Objective To evaluate the clinical significance of orthotopic continent detenial sigmoid neobladder.Methods 12 patients with bladder cancer were admitted and underwent radical cystectomy and detenial sigmoid neobladder.Results All the 12 patients were followed up for a mean of 18.6 months(range from 6 to 29 months).The blood Cr and BUN levels were both in the normal range without acidosis in all the cases.Only 1 had unilateral ureteral urine reflux during cystography.Of the 12 patients,11 cases(91.7%) achieved continence during daytime;2 cases(16.7%)were incontinent at night,but 1 case could control uri- nation by being woken up at night.The capacity of the neobladder was 220 to 550ml with a mean of 350ml and the maximal pressure of the neobladder during filling was 15 to 55cm H_2O(1cm H_2O=0.098kPa)with a mean of 35cm H_2O.Conclusion As a simple operation the detenial sigmoid neobladder can be performed easily with less complications and more reliable results.This operation may be generally applied in clinical practice.

[Objective]To evaluate long-term therapeutic effect of high tibial osteotomy HTO in the treatment of varus knee osteoarthritis.[Method]Eighteen males(twenty four knees)and eighty four females(ninety one knees)were accept HTO,patients were from thirty-five to sixty-five years,with average age 52.32(35～65)years.[Result]Ninety one knees were followed up from 10 years and 2 months to 21 years and 9 months,average 15 years and 1 month.HSS criterionwas used as evaluation standard,the ratio of excellent and good post operation 0.5 year,1 year,2,5,10,15 years were 98%,98%,98%,96%,78%,57%.[Conclusion]The therapeutic effect of HTO is good in the first 15 years,but it obviously degrade after 15 years,and HOA can work against time for prolongation of period before the possible later total knee replacement.

Objective To quickly pinpoint and correct errors in the application level in No.1 Military Medical Project. Methods LogMiner, a powerful tool provided by Oracle was used to mine and analyze the redo log files produced by oracle database in No.1 Military Medical Project. The basic concept, configuration and usage of LogMiner were described through an example of the Register Program in No.1 Military Medical Project. Results The errors made by Register Program was quickly pinpointed and then corrected by SQL statements provided by UNDO_VALUE field. Conclusion The method using LogMiner to pinpoint and correct the errors in the application level in No.1 Military Medical Project is simple, accurate and convenient. It should be a basic technique for maintenance personnel of hospital information system.

Natural killer cells (NK cells) are a class of cytotoxic lymphocytes and play an important role in anti-tumor immunity.There are many new advances from basic research to clinical applications in the 56th annual meeting of American Society of Hematology around the NK cells in Malignant hematological diseases.In this review,the progress will be given,which helps to understand the trend of NK cells in future clinical applications.

Objective:To evaluate the anti-tumor immune responses of nureplicable recombinant vaccinia virus-based vaccine expressing HPV16 L1 and L2E7 proteins.Methods:The anti-tumor effects of the vaccine were observed using mouse models of prophylactic,therapeutic and tumor excision.The cell-mediated immunity induced by the vaccine was assessed by enzyme-linked immunospot (ELISPOT) and cytotoxic T lymphocyte (CTL) assay.Results:The vaccine could protect 60% and 50% mice from the challenge of HPV16-positive tumor cells in prophylactic and therapeutic mouse model,respectively.It could protect from recurrence of the tumor in 70% mice of the excision model.The differences among the groups were significant.Strongly specific cell-mediated immunity was found using ELISPOT and CTL assay.Conclusion:The ideal anti-tumor immune responses can be induced by NTVJL1/L2E7 vaccine in mice and it can be considered to be one candidate vaccine of cervical cancer.

Objective To investigate the streptomycin(SM)-resistance of Mycobacterium tuberculosis (MTB) in urine and to examine their relationships with the mutation of rspL gene. Methods 47 strains of MTB were isolated from the urine of patients with renal tuberculosis.The mutation of rspL gene were analyzed by PCR-SSCP with silver-staining,and the strains were tested for the sensitivity to streptomycin. Results All the 47 strains had positive expression of rspL gene of MTB,with 28 SM-resistant and 19 SM-sensitive.Among the 28 SM-resistence strains 19(68%) had rspL gene mutation by SSCP testing.The 19 strains of SM-sensitive had no mutation. Conclusions Detecting mutation of MTB rspL gene in urine by PCR-SSCP can rapidly and exactly identify the MTB's sensitivity to streptomycin,which is significantly important in clinical treatment of anti-tuberculosis.

Tetrahydrobiopterin (BH4) is an essential cofactor for all three nitric oxide synthase (NOS isoforms), which plays an important role in vascular diseases. GTP cyclohydrolase 1 (GCH 1) is the first-step and rate-limiting enzyme for BH4 biosynthesis in its de novo pathway. Common GCH1 gene variant C+243T in the 3'-untranslated region predicts NO excretion. The present study examined the predictive role of GCH 1 gene 3'-UTR C+243T variant in the long-term outcome of ischemic stroke. A total of 142 patients with first-onset ischemic stroke were recruited and detected for genotype of GCH1 3'-UTR C+243T by a TaqMan SNP Genotyping assay. Subsequent vascular events and death were determined over a 5-year follow-up period. The frequency of GCH1 3'-UTR +243 C/T or T/T genotype was significantly increased in patients with endpoint events as compared with those without events (74% vs 57.8%, P=0.06). Cox regression survival analysis indicated that an increased probability of death or new vascular events was found in patients with GCH1 3'-UTR +243 C/T or T/T genotype compared with those with GCH1 3'-UTR C/C genotype (40.6% vs 25.5%), GCH1 3'-UTR +243 C/T or T/T genotype relative to GCH1 3'-UTR C/C genotype was associated with the increased risk of death or vascular events even after adjustment for other risk factors (OR=2.171, 95% CI: 1.066-4.424, P=0.033). It was concluded that GCH1 3'-UTR C+243T variant was an independent predictor of worsening long-term outcomes in patients with first-onset ischemic stroke.

Objective To study the killing effects of the killer cell immunoglobulin-like receptors (KIR)2DS1-mediated natural killer (NK) cells against dendritic cells (DCs) and analysis the expression of chemokine receptor CCR7 after KIR2DS1-positive NK cells interact with the C2 epitope DCs in vitro,and explore the mechanism of alloreactive NK cell to limit graft-versus-host disease (GVHD).Methods NK cells were separated by Rosettesep NK sorting kit from healthy donor peripheral blood and taken as effector cells.The mononuclear cells from peripheral blood of newly diagnosed acute myeloid leukemia (AML) patients,and DCs were induced as target cells.Polymerase chain reaction and sequence specific primers (PCR-SSP) genotyping techniques and direct sequencing SBT were used to detect KIR gene,HLA-Cw of the healthy donors and patients.The cytotoxic activity of KIR2DS1-positive NK cells or KIR2DS1-negative NK cells against DCs were detected by CCK-8 assay.The expression of CCR7 after NK cells interacted with DCs was detected by flow cytometry.Results The purity of NK cells analyzed by flow cytometry was (94.20±1.23) ％.Under same target ratio (10∶1),the killing effect of KIR2DS1+ NK cell against DCs was higher than that in KIR2DS1-NK cells (t =3.70,P ＜ 0.05).Under same target ratio (10∶1),the cell lysis in C1/C1 group,KIR2DS1+ NK cells against C2/C2 group DCs (15.06±1.81) ％ was significantly higher than that against C1/C1 group (10.07±1.03) ％ and C1/C2 group (8.65±0.93) ％ DCs (F =56.368,P =0.001).KIR2DS1 + NK cells efficiently acquired CCR7 upon coculture with C2 epitope DCs.Conclusions NK cell expressing the KIR2DS1-activating receptor efficiently kill DCs,prevent GVHD,while enable NK cell acquire CCR7,obtaining migratory properties in vitro.

BACKGROUND: With the development of neural interventional therapy, the application of covered stents in neural intervention is becoming a topic of general interest.OBJECTIVE: To introduce the structure of stent-graft, and to summary the application of covered stents in clinical treatment of the neural interventional therapy and the shortage of covered stents.RETRIEVAL STRATEGY:The relevant articled were searched for in Pubmed database by researcher of this article with the key words of "stent graft, covered stents, cerebrovascular disease" in English, and with the key words of "covered stent, cerebrovascular disease" in Chinese in VIP database. 223 English and 196 Chinese articles were selected and reviewed primarily. Inclusive criteria: Articles having a close relation with the application of covered stents in neural intervention, especially in cerebrovascular disease, and the latest articles or articles published in authority journals in the same field were chosen. Exclusive criteria: articles with repetitive studies were excluded.LITERATURE EVALUATION: 223 English and 196 Chinese articles were primarily checked by reading titles and abstracts. Among the 31 collected articles, 4 are reviews, 3 are experimental studies and others are clinical studies.DATA SYNTHESIS: Covered stents show special advantages in neural interventional therapy and become a hot spot in present study. There are individual case reports or small group case reports on the application of covered stents in hemorrhagic cerebrovascular disease. It is reported that the covered stent effectively occludes aneurysm, dissecting aneurysm and arteriovenous fistula, keeps patency of the parent artery. The covered stent isolates ulcerated plaque via physical barriers, avoids the abscission of embolus, which can further reduce the development of embolism in percutaneous carotid artery stenting. After releasing covered stents, polytetrafluoroethylene makes the disepiment smooth. Its good biocompatibility reduces thrombosis, and then decreases the incidence of restenosis. Covered stents in vessel for cerebrovascular disease have achieved good effects, but there are some problems in clinic as follows. ①The main shortage of covered stents is to occlude small branch vessels. ②Thrombosis and restenosis occur after covered stenting. ③Covered stents increase the volume of the stent, reduce the compliance and flexibility of the stents, and increase the pushing difficulty and vascular injury. ④Covered stents cannot be used in vessels of less than 4 mm.CONCLUSION: Covered stents for intracranial ischemic and hemorrhagic diseases shows significant outcomes, but there are disadvantages. With the clarification of the related theories and the improvement of new material technology, there will be a brighter future of the application of covered stents for treatment of cerebrovascular diseases.

Objective To study the expression of KISS-1 in normal endometrium and in ectopic endometri-um patients with endometriosis. Methods The expression of KISS-1 in 55 cases of normal endometrium as well in 46 cases of ectopie endometriurn with endometriosis were detected by immunohistochemicai EliVision plus method. Results The positive expression rates of KISS-1 in ectopic endometriotic tissues and in normal endometri-urn were 30.43 % and 63.64 % respectively ,and the positive expression rates in ectopic endometriotic tissues signifi-cantly lower than those in the normal endometrium( P< 0.01, P < 0.05). Conclusion The decreased expression of KISS-1 may be related to the mechanism of endometriosis.