OBJECTIVE:To observe the efficacy and safety of tadalafil combined with tamsulosin in the treatment of erectile dysfunction(ED) patients after four area division plasmakinetic enucleation of prostate (FPKRP). METHODS:Seventy patients with ED after FPKRP were randomly divided into control group and observation group,with 35 cases in each group. Both groups received FPKRP;control group was given Tamsulosin capsule 0.2 mg orally,once a day,1 d after surgery;observation group was additionally given Tadalafil tablet 10 mg,once a day,on the basis of control group. Both groups were treated for 3 months. Clini-cal efficacies of 2 groups were compared;international prostate symptom score,the levels of prostate specific antigen,the maxi-mal urinary flow rate,international erectile function questionnaire-5 score,life quality score and ADR were also compared before and after treatment. RESULTS:The total response rate of short-term therapy in observation group was significantly better than con-trol group,with statistical significance(97.14% vs. 71.43%,P<0.05). Before treatment,there was no significant difference be-tween 2 groups in terms of international prostate symptom score,the maximal urinary flow rate,international erectile function ques-tionnaire-5 score and life quality score(P>0.05). After treatment,international prostate symptom score and life quality score in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group;the maximal urinary flow rate and international erectile function questionnaire-5 score were significantly higher than before treat-ment,and the observation group was significantly higher than the control group,with statistical significance(P<0.05). There was no statistical significance in the levels of prostate specific antigen between 2 groups before and after treatment (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:For patients with ED after FPKRP,tadalafil combined with tamsulosin can effectively improve erectile function,relieve the lower urinary tract symptoms and improve the quality of daily life with good safety.

To study the possible etiopathology of senile cataract,the changes in the activity of lens epithelial enzyme in senile cataract and the effects of oxidative damage on the enzymatic activity of the cultured bovine lens epithelial cells. Methods 1. The activities of succinate dehydrogenase ( SDH)、 Lactate dehydrogenase ( LDH)、 Glucose - 6 - phosphate dehydrogenase (G60D) and Adenosine triphosphatase (ATPase) collected from senile cataract and normal lens epithelial cells were observed by enzyme histochemistry methods. 2. An experimental oxidative damage model of cultured bovine lens epithelial cells in vitro was established. Then the activities of SDH、 LDH and G6PD were observed after oxidative damage and then,after VitC treatment. Results 1. The activities of SDH、 LDH、 G6PD and ATPase of senile cataract lens epithelial cells were apparently lower than those of normal transparent lens.2. After oxidative damage, the activities of SDH、 LDH and G6PD of cultured bovine lens epithelial cells dramatically decreased. Vitamin C partly raised the enzyme activities, rather than bring them to normal.Conclusion Activities of enzyme related with energetic metabolism are decreased following oxidative damage, which may be a possible cause of senile cataract.

Objective Negative pressure aspirator clogging ( OSAC) frequently occurs in orthopedic surgery .This study was to investigate the frequency , location , and mechanisms of OSAC in China by analysis of the current status and clinical observation of OSAC so as to provide evidence for the solution of the problem . Methods Using the two-stage random sampling method , we conduc-ted a questionnaire survey on OSAC among 738 clinical orthopedists during the 16th and 17th Chinese Orthopedic Association Confer-ences.Totally, 160 out 1200 orthopedic surgeries were randomly selected in the time order of operation , including 38 cases of total hip arthroplasty ( THA) , 39 cases of total knee arthroplasty ( TKA) , 43 cases of extremity and spinal fractures surgery , and 40 cases of other orthopedic surgeries .We also obtained the satisfaction scores with the existing aspirators from related medical professionals . Results Among the 738 respondents included into the analysis , 706 (95.7%) thought that OSAC often occurred during surgery , 631 (85.5%) considered THA to be the leading cause of OSAC , and 714 (96.7%) regarded the tip and hose joint of the aspirator as the common causes . The mean satisfaction score with the existing aspirators was 7.62 ±0.74.Clinical observation showed the mean frequency of OSAC to be 2.55 ±1.62 in THA, 1.95 ±1.33 in TKA, 1.52 ±1.18 in extremity and spinal fracture surgeries , and 0.95 ± 0.68 in other orthopedic surgeries , and the satisfaction score to be 7.36 ±0.84. Conclusion OSAC has a high incidence rate during orthopedic surgeries in China , thus affecting orthopedic surgery and reducing orthopedists'satisfaction with the aspirators . The current negative pressure aspirator system demands prompt improvement .

Objective:The implementation of a multidisciplinary team (MDT) approach for palliative treatment of patients with multi-ple primary carcinomas (MPCs) was evaluated in Tianjin Medical University Cancer Institute and Hospital. Methods:A total of 40 pa-tients with MPCs who attended the consultation by MDT in our hospital from January 1, 2014 to April 21, 2016 were analyzed retro-spectively. Clinical data of the 40 cancer patients were reviewed. The essential characteristics and results of MDT treatment decisions were summarized and expected outcomes were evaluated. Results:A total of 40 cases with MPCs were included in MDT assessment, accounting for 6.4%of the 629 patients who were handled by the MDT. A total of 39 MDT decisions were followed up successfully. Among these MDT decisions, 26 (65%) were fully implemented, 7 (17.5%) were partially implemented, and 6 (15.0%) were unimple-mented. Expected outcomes were achieved in 25 (96.2%) patients of the fully implemented concordant group, 4 (57.1%) patients of the partially concordant group, and 1 (16.7%) patient from the unimplemented group. Conclusion:MDT specializing on palliative treat-ment can provide recommendations for standardized individualized comprehensive treatment of patients with MPCs. MDT modality should be further improved and widely used for palliative treatment.

BACKGROUND:Autologous tissue-engineered bone marrow mesenchymal stem cel s (BMSCs) transplantation is one of the most common methods of treating early osteonecrosis of femoral head, but now there is stil no any special-purpose grafter available in the market. Such surgical transplantation is a laborious, time-consuming and tedious process, which goes against its clinical promotion. OBJECTIVE:To develop a supporting, efficient, special-purpose grafter, to solve the difficulty in stem cel s transplantation during core decompression of femoral head. METHODS:CAD software was used to perform solid modeling for this special-purpose grafter and print them by three-dimensional (3D) fast printing technology. The performance of this special-purpose grafter was tested by femoral head core decompression combined with BMSCs transplantation. It was compared with traditional surgical instrument in terms of duration of operation, intraoperative blood loss, visual analogue scale (VAS) of stem cel/biological fiber col agen complex omission amount and doctor’s satisfaction score. RESULTS AND CONCLUSION:(1) A kind of special-purpose grafter was developed by 3D printing technology rapidly. (2) Compared with the control group, duration of operation, intraoperative blood loss, VAS scores and doctor’s satisfaction scores were significantly improved in the trial group (P<0.05). (3) CAD software combined with 3D printing technology is a highly efficient means for front-line clinicians to perform independent development. The research and development of this special-purpose grafter provides a perfect solution to the laborious, time-consuming and tedious process of cel/biological col agen fiber transplantation.

With the increasing understanding of the unique tumor microenvironment in the brain, immunotherapy have emerged as a new and promising treatment for brain metastases. Radiotherapy and immunotherapy have a synergistic effect, and it is of great value to understand its mechanism in the treatment of breast cancer brain metastases. At present, the study of immune checkpoint inhibitors combined with radiotherapy in breast cancer brain metastases is being actively carried out, bringing new hope to patients with breast cancer brain metastases.

Humans ; East Asian People ; Nausea/drug therapy* ; Vomiting/drug therapy* ; Antineoplastic Agents/adverse effects* ; Neoplasms/drug therapy*

The integrity of lysosomes is of vital importance to survival of tumor cells. We demonstrated that LW-218, a synthetic flavonoid, induced rapid lysosomal enlargement accompanied with lysosomal membrane permeabilization in hematological malignancy. LW-218-induced lysosomal damage and lysosome-dependent cell death were mediated by cathepsin D, as the lysosomal damage and cell apoptosis could be suppressed by depletion of cathepsin D or lysosome alkalization agents, which can alter the activity of cathepsins. Lysophagy, was initiated for cell self-rescue after LW-218 treatment and correlated with calcium release and nuclei translocation of transcription factor EB. LW-218 treatment enhanced the expression of autophagy-related genes which could be inhibited by intracellular calcium chelator. Sustained exposure to LW-218 exhausted the lysosomal capacity so as to repress the normal autophagy. LW-218-induced enlargement and damage of lysosomes were triggered by abnormal cholesterol deposition on lysosome membrane which caused by interaction between LW-218 and NPC intracellular cholesterol transporter 1. Moreover, LW-218 inhibited the leukemia cell growth