OBJECTIVETo evaluate the value of taking surgical margin specimens during transurethral resection of bladder tumor(TURBT) in the diagnosis and treatment of non-muscle invasive bladder cancer.

METHODSThe data of 356 patients with non-muscle invasive bladder cancer from June 2009 to January 2014 were analyzed retrospectively. A standardized protocol were performed during TURBT in 176 patients(surgical margin group), by taking surgical margin specimens from tumor base and 'normal'-appearing margin sites. The other 180 cases merely received general TURBT (general group). To observe the positive rate of surgical margin specimens and whether the diagnosis and treatment plan changed in the surgical margin group. Using Chi-square test to compare the recurrence and progression rates between surgical margin and general groups. To compare their recurrence-free survival time by Mann-Whitney U test. Results Of these 176 surgical margin specimens, the positive rate was 19. 3% (34/176),which consists of tumor base 11. 9% (21/176) and tumor normal-appearing margin 7. 4% (13/176). Following with urothelial carcinoma Ta stage in 1. 7% (3/176), T1 stage in 5. 7% (10/176), T2 stage in 8. 0% (14/176), carcinoma in situ (Tis) in 4. 0% (7/176). Among these 176 patients final diagnosis were changed in 10. 8% (19/176) patients due to the specimens results, and 18. 2% (32/176) patients altered their treatment plans. All 356 patients with a mean follow-up of 36. 8 months (6 to 60 months). Two groups of patients(surgical margin group vs. general group) recurrence rates respectively were 22. 2% (39/176) vs. 35. 6% (64/180), recurrence-free survival time were 33. 0 months vs. 23. 5 months and progression rates were 5. 7% (10/176) vs. 10. 6% (19/180). Compared with general group, patients who were taken additional surgical margin specimens showed significantly lower recurrence rate (χ2 = 7. 677, P = 0. 007) and longer recurrence-free survival time (U = 12 605,P = 0. 001). While the progression rate showed no statistical difference between them (χ2 = 2. 825, P = 0. 121).

CONCLUSIONTaking additional surgical margin specimens during transurethral resection of bladder tumor is helpful for pathological diagnosis and the planning of further treatment.

Carcinoma, Transitional Cell ; diagnosis ; surgery ; Cystectomy ; Disease Progression ; Humans ; Neoplasm Recurrence, Local ; Retrospective Studies ; Specimen Handling ; Statistics, Nonparametric ; Urinary Bladder Neoplasms ; diagnosis ; surgery

Objective To evaluate the application value of hip joint traction device in treating serious developmental dysplasia of the hip. Methods From April 2006 to October 2008, 6 cases Crowe Ⅳ hip dysplasia and 1 case dysplasia of acetabulum in coxa vara underwent arthroplasty. There were 2 males and 5 females with an average age of 30 years (range, 12-45). All patients were admitted to the hospital for the distraction, which was 1.0-2.0 cm on the first day and 1 mm/d thereafter, until slowly pulling femur head to the real acetabulum. Changing to the skin distraction with 3 kg, arthroplasty was performed after pin sites healing. Results Seven femur heads of 5 cases and two greater trochanters of 1 case were pulled into the real acetabulum, average distraction length was 4.45 cm, and average time was 43 d, no nerve injury and infection of pin sites. Soft tissue release and femur shortening were not required in arthroplasty. One case accelerated pulling speed to 1.25 mm/d when left femur head was distracted to 6.0 cm, so that the partial left deep peroneal nerve injury happened after 12 h. Ending distraction, bilateral THA was undergone by stages and femur shortening 3 cm in operation, nerve injury restored after half year. All patients were followed up for average 2.5 years (range, 1.5-3.0). In all patients, two limb lengths were equal, middle gluteal muscle myodynamia improved about 1-2 grades. The mean Harris hip score improved from 56.2 to 92.2 one year after operation. Conclusion The hip joint traction device could pulled femoral head to the real acetabulum rotating center, as a result, femur shortening and soft tissue release were not required while performing arthroplasty, and through which wound and operative time were decreased, middle gluteal muscle function was improved. However, we should strictly pulled the femur head at 1 mm/d to avoid nerve injury.

Rheological properties of poloxamer 407 (brand named Pluronic F127) were examined by changing shear rate, temperature and the recovery properties of apparent viscosity after heating for several times. The results indicated that poloxamer 407 aqueous solution showed a Newtonian behavior at a low concentration while it might be a pseudoplastic fluid when the concentration reached a certain point. The thixotropy and the sol-gel transition temperature decreased with increasing the concentration (it could be an in situ gel at body temperature when the concentration of poloxamer 407 up to 15.25%). The results that obtained from the theological data would be useful in the application of poloxamer 407 such as in situ gel preparation.

Objective Studies on IMRT technique demonstrates that the improved dose homogeneities throughout the breast as well as reduction in dose to the heart and the ipsi-and control-lateral lungs. Methods Based on the physical principle of rolling tangential technique, a treatment plan for a patient has been planned by using Pinnacle aperture-based inversion software. The rolling tangential IM-beam was pre-determined at each pre-selected gantry angle with normally angle separation of 5?, 10? or 15?. Each beam's width was so chosen that the inner-and outer-edge of the beam should be tangential to the inner chest wall and target outer surface respectively. For the starting and ending tangential beam, a pair of opposing beam was designed. The beam's orientation was suggested to be reversed to its opposite angle when the tangential beam's gantry angle reached 90? or 270?. Each beam's shape and size were adjusted on its BEV map. For each tangential beam, 7 sub-segment beams were chosen for each tangential beam. Then, planning system was allowed to do optimization according to the clinical dose prescriptions. Results The calculated dose distributions in target(CTV), left & right lungs, and heart showed that the volume received the prescribed dose 50?Gy V_ 50 was 0.95; The volume in target enclosed with 95%, 105%, 110%, 115% isodose lines V_ 95% , V_ 105% , V_ 110% , V_ 115% was 0.98, 0.84, 0.53, 0.18, respectively. The volume of V_ 10 ,V_ 20 , V_ 30 , V_ 40 V_ 50 , in the lungs and heart were significantly decreased when compared to the current IMRT techniques published in the literature(Table 1).Conclusions The rolling tangential IM-segment irradiation technique for the breast developed by the author is able to offer not only a better dose distribution and better dose conformity throughout the target, but also reduce significantly the dose to the lungs and heart, with the patient's set up and localization process being very simple. The treatment planning for individual patient is optimal in any treatment planning system with Aperture-Optimization inverse software. This technique is certainly to offer more benefit to the patient if some measures are taken to limit or to follow the movement of the chest wall during irradiation.

Objective To study mathematical model and to perform computer simulation for an important subsystem in the bioregenerative life support system(BLSS),i.e.,light-algae bioreactor(LABR)forcontinuously cultivating green microalgae andsignificantly maintaining life support function of BLSS.MethodsBased on the theories of system dynamics and stoichiometry,the mathematical model and simulation model of LABR were respectively established with experimental data,and then computer experiments were conducted to simulate dynamic responses of LABR under different parameters as well as their combinations.Results It was shown that the kinetic model of LABR was valid for its real-life counterpart by a series of verification tests.It could reliably and beneficially provede technical and methodologcal helps for further investigations of LABR,such as theoretical analysis,design,control and optimization,and so on.Conclusion With computer experiments based on mathematical model and simulation model,it decreases much more in time and money consumption for investigations than with real experiment.This method can also be extended to use in other subsystems studies of BLSS.

Objective To understand the clinical characteristics and correlative factors of ANCA-associated systemic vasculitis with interstitial lung disease.Methods Seventy-five AASV patients in Shanghai Renji Hospital from January 2010 to June 2013 were selected.The clinical data of those cases with interstitial lung disease were analyzed retrospectively and logistic regression model was applied to analyze the correlative factors.Results Of the 75 AASV patients,52％ were male,48％ were female,and the average age was (56±19) years.Forty-four cases were defined as interstitial lung disease.Among patients with interstitial lung dis-ease,31 (70％) cases were chronic onset,32(72％) cases had pulmonary infection and 8 (18％) cases died.The main chnical manifestations were dry cough,shortness of breath after labour and fever,the proportion was 68％,36％ and 50％ respectively.Irregular linear shadow was the main imagine changes,the rate was 55％.Pulmonary function changes varied in degrees with diffusion capacity reduction.Multivariate logistic regres-sion analysis showed that those who were older than 60 years (OR=3.44,95％CI:1.05-11.28),positive for MPO-ANCA (OR=3.7,95％CI:1.10-12.65) and Birmingham vasculitis activitv score higher than15 (OR=3.67,95％CI:1.21-11.15) were more likely to have interstitial lung disease.Conclusion Interstitial lung disease is one of the common pulmonary damages of ANCA-associated systemic vasculitis and it will lead to death because of respiratory failure or secondary pulmonary infection.Those who are elders,with positive MPO-ANCA,and with active disease are at high risk for interstitial lung disease among AASV patients.The results of this study sugest that clinicians should pay more attention to patients with these high risk factors.

Objective To prepared the docetaxel nano liposome (L-DOC) for the therapy of liver cancer HepG2 cells in vitro and in vivo. Methods The film-ultrasonic dispersion method was used to prepare the L-DOC.The diameter and Zeta potential of L-DOC were determined by Nanosizer and the encapsulation efficiency was further measured.CCK-8 method was used to determine the cell viability of HepG2 cell after treating with various concentration of DOC and L-DOC respectively and the cell death type was detected by Flow cytometer.Next, we have studied the relative tumor volume change of tumor-bearing mice and the toxicity in vivo.Results The average diameter of L-DOC was 104 nm and the Zeta potential was about -35.1 mV.The Zeta potential of L-DOC was almost unchanged after standing for 96 hours.The encapsulation efficiency of L-DOC was ( 71.2 ±1.6 )%.The CCK-8 results showed that the cell viability was decreased after treating with various concentration of DOC and L-DOC, but the inhibition effect of L-DOC was better than that of DOC after treating with the same dose, especially for 20μg/mL.It was found that the cell death was induced by apoptosis.The in vivo study results showed that 6mg/kg L-DOC could inhibit the tumor volume better than that of same dose of DOC.In addition, 6mg/kg L-DOC and DOC didn’ t induce in vivo toxicity.Conclusion The L-DOC is prepared by film-ultrasonic dispersion method which has small diameter, great biocompatibility.And it could inhibit the HepG2 cells in vitro and in vivo, especially for no in vivo toxicity.

Objective To summarize extracorporeal membrane oxygenation (ECMO) in percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) with cardiac arrest,and to evaluate the clinical efficacy comparing with literature review.Methods 5 patients of AMI with cardiac arrest who proved invalid to conventional cardio-pulmonaryresuscitation (CPR),were successfully resuscitated with ECMO support,and underwent emergency PCI with stable hemodynamic status.Results In support of ECMO,4 patients were successfully resuscitated with stable hemodynamic status,and underwent primary PCI.The duration of ECMO support ranged from 42 to 220 h (average 126.6 h).3 patients discharged with full recovery,one patient didn't wean from ECMO successfully,and one died of respiratory failure.Conclusion Although mortality of AMI with cardiac arrest is high,early ECMO-assisted cardiopulmonary resuscitation and secondary PCI treatment increase the possibility of cardiac recovery,and provide conditions for emergency revascularization treatment.This reduces mortality in critical patients with AMI,and is an effective short term life support method.

Objective To evaluate the relationship between the CCNE1 or RIP2, identified at a single nucleotide poly?morphism, and the risk, clinic stage and pathological grade of bladder cancer. Methods Peripheral venous blood samples were obtained from 176 patients with bladder cancer and 210 controls without cancer. DNA was extracted. Polymerase chain reaction (PCR) method was used to detect CCNE1 (rs8102137) and RIP2 (rs42490) polymorphism. According to the postoper?ative pathological results, patients with bladder cancer were determined the grading and staging. The genotype differences of medium gene and the distribution gene were analyzed and compared in bladder cancer group and control group. The relation?ship of CCNE1 (rs8102137) and RIP2 (rs42490) genotypes and clinical data of patients with bladder cancer was analyzed, and the relationship of them with the genetic susceptibility to bladder cancer was also analyzed. Results The genotype dis?tribution was with good group representative in control group. The frequency of CCNE1(rs8102137) variant allele was signifi?cantly higher in bladder cancer group (40.91%) than that of control group (30.95%,OR=1.54,95%CI:1.02-2.45, P<0.05). The frequency of RIP2 (rs42490) variant allele was significantly higher in bladder cancer group (72.73%) than that of control group (62.38%, OR=1.61, 95%CI:1.04-2.48, P<0.05). There were no significant differences in gene polymorphisms of CC?NE1(rs8102137) and RIP2 (rs42490) between different pathological grades and different clinical stages of bladder cancer. Conclusion The CCNE1 (rs8102137) and RIP2 (rs42490) polymorphism have interaction in occurrence of bladder cancer process. There is higher risk of bladder cancer in individuals carrying mutant alleles than that of individuals carrying wild type.

Mitogen-activated protein kinases (MAPKs) are important signaling transduction components well conserved in eukaryotes and play essential roles in various physiological, developmental and hormonal responses in plant. In the present study, a MAPK gene, designated as DoMPK4 (GenBank accession No. JX297597), is identified from a rare endangered medicinal orchid species D. officinale using the reverse transcription polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE) methods. The full length cDNA of DoMPK4 is 1 518 bp in length and encoded a 369 aa protein with a molecular weight of 42.42 kD and an isoelectric point of 5.55. DoMPK4 protein contained a serine/threonine protein kinase active site (158-170), a MAP kinase site (71-174), and eight conserved motifs. DoMPK4 had a transmembrane (214-232) but no signal peptide. Multiple sequence alignment showed that DoMPK4 shared high identities (74.9%-80.6%) with MAPK proteins from various plants. Phylogenetic analysis demonstrated that DoMPK4 belonged to group A of the MAPK evolutionary tree, and is closely related to monocots. Real time quantitative PCR (qPCR) analysis revealed that DoMPK4 is differentially expressed among the five organs including leaf, stem, root, seed, and protocorm-like body (PLB). The transcription level of DoMPK4 is the highest in the PLBs with 17.65 fold, followed by seeds, roots, and stems with 5.84, 2.28, and 1.64 fold, respectively. The progressive enhancement of DoMPK4 transcripts in the developing PLBs compared to that in the germinating seeds, suggests a role of DoMPK4 during the development of embryogenic PLBs formation in D. officinale.