Objective To observe the results and reality of transurethral resection of bladder tumor(TUR-Bt) with upside down loop and plsamakinetic in the prevention of obturator nerve reflex.Methods A total of 211 patients with lumbar anesthesia received TUR-Bt.Firstly,the tumor tower above bladder wall was cut with the traditional way.When intraoperative findings were obturator nerve reflex,or to the obturator nerve mapping area,operation should be changed to superimpulse plasma column electrode vaporization to cut off residual tumor tissue,then after flipping the loop,the residual tumour was resected with upside-down loop from the tumour side wall.Results In 211 cases,192 cases had a little obturator nerve reflex,but the movement of body was not obvious,which did not influence the operation.The serious complication,such as perforation of bladder and injury of nerve and vessel,did not occur.Conclusions The lateral resection of bladder side wall tumour with upside-down loop can effectively avoid strong obturator nerve reflex,which is safe,uncomplicated,and efficacious and it does not increase the additional outlay and hurt.

1.The external features and arterial supply of the papillary muscles of the leftventricle were studied in 54 human,52 dogs' and 110 rabbits' hearts.Radiopaquemedium or Chinese ink were injected into coronary arteries.After injection,arter-iography of some hearts were taken,and serial celloidin sections of the papillarymuscles of other hearts were made.The diameters of the papillary arteries and thedensity of the vessels were measured.2.The papillary muscles could be divided into three patterns,depending on theextent of their attachment to the ventricular wall and the relative length of theirfree part protruding into the ventricular cavity.The three patterns were as follows:(1)The attached type,the papillary muscle was largely adherent to the sucbjacentventricular myocardium,with only one third or less of its length protruding into theventricular cavity(34% in human hearts,100% in dogs' and 38% in rabbits').(2)The free type,the free end of the papillary muscle was one half of its length ormore(28% in human hearts,10% in rabbits').(3)The intermediate type,thelength of the free protruding part of the papillary muscle was intermediate between(1)and(2)(38% in human hearts,52% in rabbits').3.In the human and the dogs' hearts the anterolateral papillary muscle receivedbranches from the anterior descending artery and the diagonal left ventricularbranches or the left circumflex artery;while in the rabbits' it received branchesmainly from the anterior branches of the left ventricular artery.The posteromedialpapillary muscle received a variable supply from the left circumflex artery and orthe branches of the right coronary artery in the dogs' hearts and in the human hearts,while in the rabbits' hearts,it mainly received branches from the posteriorbranches of the left ventricular artery.4.The arrangement of the arterial vasculature of the papillary muscle seemedto be related to the different patterns of the papillary muscles.The free typereceived a large central artery which coursed through the entire papillary muscle toits apex(87.5%).The attached type had a segmental supply of 3～9 long penetrat-ing intramyocardial vessels(94.29%).The intermediate type had a combination ofboth types of vascular arrangement(98.5%).5.The average diameter of the central arteries was 617.50 ? in human hearts atits entry into the base of the papillary muscle,and 236.05 ? in rabbits.The dia-meters of the segmental arteries were 323.60 ? in human hearts,300.05 ? in dogs',121.78 ? in rabbits' respectively.The diameters of the capillary vessels were 5～8 ?in human hearts,3～6 ? in dogs',2.5～6 ? in rabbits' respectively.The numbersof capillaries that observed in a length of 200? were 15.45 in human hearts,16.2in dogs',19.3 in rabbits'.The specific values of the density of vessels per unitarea were 34.4% in human hearts,34.1% in dogs',56% in rabbits'.

OBJECTIVETo investigate the expression of Caspase-3 and Hsp70 in rabbits after severe traumatic brain injury (TBI) and to explore the feasibility of its application in estimation of injury time in forensic medicine.

METHODSA rabbit model of heavy TBI was developed by high velocity impact on the parietal bone with an iron stick. Totally 8 healthy adult New Zealand white rabbits were randomly divided into control group (n equal to 2) and injury group (n equal to 6). Four hours after injury, tissue specimens from the parietal lobe, temporal lobe, occipital lobe, cerebellum and brainstem were harvested to detect the expression of Hsp70 and Caspase-3 by immunohistochemistry. Besides, the gray values of cells positive for Hsp70 and Caspase-3 were analyzed with an image analyzer.

RESULTSImmunohistochemistry staining demonstrated a low level of Caspase-3 and Hsp70 expression in normal control group. While in injury group, both the Caspase-3 and Hsp70 expression was significantly elevated (P less than 0.05). Positive cells gathered around the lesion focus. Occipital lobe and cerebellum had fewer positive cells while temporal and brainstem had the fewest.

CONCLUSIONThe expression of Caspase-3 and Hsp70 at an early stage following severe TBI is characteristic and can be applied to estimate the time of injury.

Animals ; Brain Injuries ; metabolism ; Caspase 3 ; metabolism ; HSP70 Heat-Shock Proteins ; metabolism ; Immunohistochemistry ; Rabbits ; Random Allocation

Objective:To investigate the negative effect of the IL-10 on monocyte-derived DC maturation and differation iv vitro,and the potentiation of the TNF-? or sCD40L to inhibit or reverse the IL-10′s inhibitory effect on monocyte-derived DC.Methods:The expression of the surface molecules on DC was detected by FACS analysis.The potentiation to stimulate T cell proliferation was assayed by 3H-TdR incorporation,and IL-12 secretion in the DC supernatant measured by ELISA.Results:In vitro DC-inducing system IL-10 had an obviously negative effect on the maturation as well as the potentiation to stimulate the T cell proliferation and IL-12 secretion of the immature monocyte-derived DC,and IL-10 could drive monocyte-derived DC differentiate into the macrophages.The negative effect was also correlative to the concentration of the added IL-10;The results also showed that IL-10 hadn′t any negative effect on mature DC induced by sCD40L,but to some extent could reduce the mature DC induced by TNF-? to produce IL-12;Furthermore the inhibitory effect of IL-10 can′t be reversed by adding TNF-? or sCD40L after IL-10 was added to the DC-inducing culture system for three days.Interesting by adding sCD40L not TNF-? to the DC-inducing culture system with IL-10 at the same time can inhibit the negative effect of IL-10 completely.Conclusion:IL-10 is an important biological factor produced in tumor microenvironment for escaping the attack of the immune system by repressing maturation,potentiation to costimulate the T cells and IL-12 secretion of the immature monocyte-derived DC.The reverse effect of TNF-? and sCD40L on IL-10 negative effect on monocyte-derived was different.All together suggested that CD40 signal has important values to obtain the therapeutic DC for the tumor immune intervention.

OBJECTIVETo observe the long-term changes in anxiety-like behavior and tyrosine hydroxylase (TH) expression in the substantia nigra (SN) after hypoxic-ischemic brain damage (HIBD) in a neonatal rat model and to further explore the relationship between dopamine (DA) level and long-term anxiety-like behavior using the DA receptor (DAR) antagonist.

METHODSSeven-day-old (P7) neonatal Sprague-Dawley (SD) rats were randomized into normal control, sham-operated, HIBD and HIBD+DAR antagonist groups. HIBD model was prepared by ligating the right common carotid artery and 8% hypoxia exposure. The rats in the sham-operated group were sham-operated and were not subjected to right common carotid artery ligation and hypoxia exposure. The DAR antagonist was injected intraperitoneally before and after inducing HIBD. The same amount of normal saline was given to the other three groups as a control. Anxiety-like behavior was evaluated by elevated plus maze test, and TH expression in the SN was measured by immunohistochemistry on P14, P21, and P28.

RESULTSOn P21 and P28, the time spent in the open arms and the percentage of open arms entries in the HIBD group were significantly increased compared with those in the normal control, sham-operated and HIBD+DAR antagonist groups (P<0.05); in addition, the HIBD+DAR antagonist group showed a significantly longer time spent in the open arms than the normal control group (P<0.05). On P14, P21, and P28, TH expression in the HIBD and HIBD+DAR antagonist groups was significantly lower than that in the normal control and sham-operated groups, and TH level in the HIBD group was significantly lower than that in the HIBD+DAR antagonist group (P<0.05).

CONCLUSIONSDAR antagonist allows the restoration of anxiety-like behavior and alleviates the damage to dopaminergic neurons in SD rats after HIBD.

Animals ; Animals, Newborn ; Anxiety ; etiology ; prevention & control ; Dopamine Antagonists ; therapeutic use ; Hypoxia-Ischemia, Brain ; complications ; Maze Learning ; Rats ; Rats, Sprague-Dawley ; Receptors, Dopamine ; physiology ; Substantia Nigra ; enzymology ; Tyrosine 3-Monooxygenase ; analysis

OBJECTIVE: To investigate the biomechanical characteristics of retinaculum in the treatment of femoral neck fractures. METHODS: The CT data of a 75-year-old female volunteer was processed by software to construct an intact femur model and femoral neck fracture model fixed with three cannulated screws, which were divided into models with retinaculum or not. The Von-Mises stress distribution and displacement were compared to analyze the stability differences between the different models to study the mechanical characteristics of the retinaculum in the treatment of femoral neck fractures. RESULTS: In the intact femur, the most obvious displacement appeared in the weight-bearing area of the femoral head, with retinaculum 0.381 37 mm, and without retinaculum 0.381 68 mm. The most concentrated part of the Von-Mises stress distribution was located in the medial and inferior part of the femoral neck, with retinaculum 11.80 MPa, without retinaculum 11.91 MPa. In the femoral neck fracture fixed with three cannulated screws model, the most obvious position of displacement also appeared in the weight-bearing area of the femoral head, with retinaculum 0.457 27 mm, without retinaculum 0.458 63 mm. The most concentrated part of the Von-Mises located at the medical and inferior part of the femoral neck, with retinaculum 59.22 MPa, without retinaculum 59.14 MPa. For the cannulated screws, the Von-Mises force peaks all appeared in the posterior and superior screw, with retinaculum 107.48 MPa, without retinaculum 110.84 MPa. Among the three screws, the Von-Mises stress of the anterior-superior screw was the smallest, which was 67.88 MPa vs 68.76 MPa in the retinaculum and non-retinaculum groups, respectively. CONCLUSION The complete retinaculum has little effect on the stability of intact femur and femoral neck fractures with anatomical reduction after internal fixation, and cannot effectively improve the stability of the fracture end after the fracture.
Female ; Humans ; Aged ; Finite Element Analysis ; Femoral Neck Fractures/surgery* ; Fracture Fixation, Internal ; Bone Screws ; Femur Neck ; Biomechanical Phenomena

OBJECTIVETo study the cost of the hypertensive outpatients.

METHODSThe study randomly selected 460 insured patients with hypertension and investigated their cost on each case in the out-patient department through 2002, based on the electronic system of medical insurance.

RESULTSAs a whole, the distribution of hypertensive outpatient expenditure takes on the positively skewed, with the median of 1 567.9 Yuan RMB. With the increase of age, the average expenses in each age group increased accordingly. In the study, the average number of outpatient attendances per patient was 19.5, the average expenses per visit was 115.4 Yuan RMB. In age groups 40 - 49 and 50 - 59, expenses of outpatient in male and female groups are obviously different in 2002 (Wilcoxon W(40 - 49) = 36, P(40 - 49) = 0.037; Wilcoxon W(50 - 59) = 374, P(50 - 59) = 0.023), as well as the number of out-patients (Wilcoxon W(40 - 49) = 52.5, P(40 - 49) = 0.007; Wilcoxon W(50 - 59) = 379, P(50 - 59) = 0.028). When considering the factors of gender and age at one time, the outpatient expenditures in the male group were significantly different between the different age groups (chi(2) = 22.3, P < 0.001), as well as the number of outpatients (chi(2) = 25.4, P < 0.001). In addition, the expenditure of drugs, which took a large proportion of the total expenditure of hypertensive outpatients (about 83.6 percent), was divided into three parts according to the degree of correlation with hypertension: direct expenses related to the with disease, the indirect expenses and the irrespective. The proportions of each part were 19.9 percent, 32.3 percent and 47.8 percent respectively.

CONCLUSIONWhen economic evaluation of community prevention is carried out, the cost and cost-benefit analysis based on the analysis of outpatient expenditure and the proportion of expenses on hypertension should be taken into account. Additionally, to provide appropriate mode of medicare, to impact the behaviors and expenditure of patients, and to provide low-cost but good effective drug are also essential and important factors.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Ambulatory Care ; China ; Female ; Health Care Costs ; statistics & numerical data ; Hospitals, Community ; economics ; statistics & numerical data ; Humans ; Hypertension ; economics ; therapy ; Male ; Middle Aged ; Outpatients ; statistics & numerical data ; Sex Factors ; Time Factors

OBJECTIVETo compare the surgical outcomes between laparoscopic and open wedge resection for gastrointestinal stromal tumors of the stomach.

METHODSClinical data of 18 cases undergoing laparoscopic wedge resection from June 2000 to August 2009 at the Zhejiang Provincial People's Hospital were compared with 30 patients treated by open surgery. The perioperative parameters and prognosis data of the two groups were compared.

RESULTSCompared to the open group, laparoscopic group was found with longer operative time, less blood loss, less requirement of postoperative analgesia, earlier resumption of oral intake, earlier return of first flatus, and shorter postoperative hospital stay(all P<0.05). There were no postoperative deaths in both groups. Postoperative complication rate was significantly lower in the laparoscopic group(5.5% vs. 33.3%, P<0.05). The postoperative recurrence rates were 11.8%(2/17) and 10.7%(3/28); the 5-year survival rates were 78% and 63%, respectively, and the difference was not statistically significant(P>0.05).

CONCLUSIONLaparoscopic wedge resection is a feasible treatment option for GISTs of the stomach.

Adult ; Female ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; diagnosis ; pathology ; surgery ; Humans ; Laparoscopy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

Adult ; Aged ; Angina, Unstable ; blood ; diagnostic imaging ; Antigens, CD ; blood ; Coronary Artery Disease ; diagnostic imaging ; Endoglin ; Female ; Humans ; Male ; Middle Aged ; Receptors, Cell Surface ; blood ; Ultrasonography, Interventional

OBJECTIVETo screen hepatocellular carcinoma (HCC) autoantibodies as diagnostic biomarkers or therapy targets by serologic proteome analysis (SERPA).

METHODSTotal proteins extracted from human HCC cell line HCCLM3 were separated by two-dimensional electrophoresis (2-DE) and then transferred onto PVDF membranes, which were subsequently incubated with sera from HCC, hepatitis B virus (HBV) infected patients or healthy volunteers. All immuno-reactive protein spots on blot films were matched to those on 2-DE gel maps by image analysis and identified by matrix-assisted laser desorption/ionization-time of flight-mass spectrometry (MALDI-TOF-MS/MS).

RESULTS2-DE gel maps of HCCLM3 and corresponding blot films of good quality and reproducibility were established. The number of spots on HCCLM3 2-DE reference gel totaled 603 and those on HCC, HBV and healthy sera blotted films were 70.75+/-24.25, 68.5+/-23.44 and 41.38+/-15.05, respectively. Blot films of HCC and HBV groups had more spots than those of the healthy group (P < 0.05) while no significance was found between films of HCC and HBV groups. By identification, those HCC autoantibodies could be classified as nuclear proteins, cytoskeleton proteins, heat shock proteins and metabolic enzymes.

CONCLUSIONSerological proteome analysis is a high throughput technique for screening tumor autoantibodies. Those newly identified HCC associated tumor antigens and corresponding autoantibodies can be used in the early diagnosis or immuno-therapy of HCC.

Antibodies, Neoplasm ; analysis ; Autoantibodies ; analysis ; Carcinoma, Hepatocellular ; immunology ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Liver Neoplasms ; immunology ; Proteomics ; methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Tumor Cells, Cultured