Objective To present the management of increasing the closure stress of urethra for treatment of stress urinary incontinence in women. Methods In 12 patients with stress incontinence the posterior urethra and the anterior wall of the bladder was incised.Then the wall of posterior urethra,bladder neck and bladder trigone were trimmed and sutured to form a tube whereby to elongate and tighten the posterior urethra referring to Campbell-Young's way and according to Laplace's law. Results The mean period of post-operative follow-up was 8.8 years.Eleven patients could completely control their urinating without residual urine after the operation.The short-term and long-term outcomes were the same in these 11 patients.For the remaining one patient little urine was spilt when the abdominal pressure was increased with exertion. Conclusions Elongating and tightening the posterior urethra is simple,effective and safe for treatment of stress urinary incontinence in women.

Objective To explore the relations between UA and serum hs-CRP, the effects of early intervention with atovastatin on serum hs-CRP in patients with UA and its clinical significance in the early management of UA. Methods T 60 patients with UA (UA group),53 patients with stable angina (SA group) and 50 healthy controls (control group) were enrolled to the study. The serum hs-CRP levels were measured by particle enhanced immunoturbidimetric assay. UA group were randomly assigned to the atovastatin group and the routine group for a 4-week treatment immediately after admission. Selected coronary artery angiography was performed in 78 patients and 29 healthy controls with Judkin's technique. Results Baseline of hs-CRP in patients with UA was significantly higher than those in SA group and control group ( P

In order to identify whether functional L-type calcium channels are expressed in neural stem cells(NSCs) from rat embryonic hippocampus, and whether L-type calcium channels participate in the modulation of proliferation and differentiation of NSCs, the rat embryonic hippocampal tissue was dispersed into a single cell suspension, and the dissociated cells were cultured in serum-free DMEM/F12 medium containing epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), N-2 and B27 supplement. Immunofluorescent labeling showed an expression of nestin-positive cells. Following five-days culture in differentiation medium, neuron-like and astrocyte-like cells were observed, which expressed ?-tubulin Ⅲ(Tuj1) and Glial fibrillary acidic protein (GFAP), respectively. Western blot analysis showed an expression of Cav1.2?1C subunits in NSCs, but no Cav1.3?1D subunits. Moreover, L-type calcium channel currents were recorded in those cells by using whole-cell patch clamp techniques. It was found that activation of L-type calcium channels promotes proliferation and differentiation to neuronal type of NSCs. The results indicated that rat embryonic hippocampal NSCs express functional L-type calcium channels, L-type calcium channels modulate proliferation and differentiation of NSCs.

Objective To study the endogenous glucocorticoid on rat femoral head microenvironment of 11 hydroxysteroid dehydrogenase expression ,and to discuss the influence of combined with femoral head pathological changes of the corresponding mechanism .Methods Sixty SD rats were divided into control group ,1‐month group ,3‐months group ,each 20 rats in group .1‐month group and 3‐months group inject cortisone acetate in the abdominal cavity intraperitoneal for 1‐month or 3‐months each .Im‐munohistochemical ,immunofluorescence ,Real‐time qPCR ,HE staining were employed in this study .Results From immunohisto‐chemical ,immunofluorescence ,Real‐time qPCR ,the 11 hydroxysteroid dehydrogenase content of 1‐month group and 3‐months group were higher than that of the control group(P<0 .05) .From HE staining we detected 1‐month group in the bone marrow cavity in‐creased in fat cells ,3‐months group subchondral trabecular bone density decreased ,compared with the control group(P< 0 .05) . Conclusion Supplement of corticosterone could promote rat femoral head microenvironment 11 hydroxysteroid dehydrogenase ex‐pression and subchondral trabecular bone density decrease .

BACKGROUND:Spinal posterior surgery is the most common treatment method for thoracolumbar fracture. During exposure of conventional posterior surgery, a wide-range stripping and pul ing of paraspinal muscles easily induced failure syndrome of lumbar surgery.
OBJECTIVE:To compare the reset conditions and stability of thoracolumbar fractures after treatment with pedicle screw paraspinal muscle approach and conventional posterior median approach fixation.
METHODA total of 62 patients with thoracolumbar fractures without nerve injury were retrospectively analyzed. 22 patients were treated with paraspinal muscle approach and general spine system. 21 patients were treated with conventional median approach and general spine system. 19 patients were treated with conventional median approach and AF internal fixation system. The therapeutic effects of the three kinds of fixation methods were compared by comparing clinical indexes in patients of the three groups, including operation time, intraoperative blood loss, postoperative drainage, dead space volume, scores of the Visual Analogue Scale of back pain, wound complications, height of injured vertebrae and the Cobb angle.
RESULTS AND CONCLUSION:Operation time, intraoperative blood loss, postoperative drainage and dead space volume were better in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group (P<0.05). No significant difference in height of injured vertebrae and the Cobb angle was detectable among the three groups at 3 days after fixation (P>0.05). No significant difference in scores of the Visual Analogue Scale of back pain was visible among the three groups at 1 week after fixation (P>0.05). The scores of the Visual Analogue Scale of back pain were apparently lower in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group at 3 and 6 months after fixation. No incision infection was observed in patients of the three groups. These results suggested that compared with conventional posterior median approach, paraspinal muscle approach has some advantages, such as smal trauma, less bleeding, postoperative rapid recovery, and high degree of satisfaction. The effects of general spine system and AF internal fixation system in the repair of thoracolumbar fractures on internal fixation are similar, but general spine system has some advantages such as simple to be operated, save time, less bleeding, stable fixation and good reduction. General spine system combined with paraspinal muscle approach is a good method to repair thoracolumbar spine fracture.

BACKGROUND:For reason of pathological particularity, treatments for young adult patients with lumbar disc herniation require more demanding procedures. Traditional discectomy and rigid fixation and fusion receive a lower clinical satisfaction rate because of their concomitant complications. Waveflex is a semi-rigid fixation system with non-fusion pedicle screws. Once combined with the technology of annulus repair, it can maintain the normal movement of the segments, and can thus raise clinical satisfaction rate. OBJECTIVE:To evaluate the short-term efficacy of the treatment of young adult lumbar disc herniation through the technology of the posterior Waveflex non-fusion pedicle screw elastic fixed smal window nucleus pulposus extirpation associated with annulus repair. METHODS: Thirty-eight patients with lumbar disc herniation were involved in this study, among which, 18 cases in the elastic fixation group were subjected to a posterior lumbar smal window nucleuspulposus extraction along with annulus repair together bound with Waveflex elastic fixation; the rest 20 cases in the nucleus pulposus removal group underwent simple nucleus pulposus extirpation. After these operations, a series of folow-up study was conducted, including: folow-up analysis of clinical efficacy and complications, colection of low-back pain visual analogue scores, colection of Japanese Orthopaedic Association scores (JOA), regular assessment of Oswestry dysfunction index, and reevaluation of the lumbar lateral radiographs related indicators. RESULTS AND CONCLUSION:Folow-up visits to the patients were conducted 12-20 months later since the operations. Both groups showed a better performance than before treatment in the pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain (P < 0.05) during the last visit. The pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain in the dynamic fixation group were superior to those in the nucleus pulposus removal group (P <0.05). Stil in the last folow-up, operative segment disc height in the dynamic fixation group was greater than that before treatment, and the operative segment range of motion was smaler than that before treatment (P <0.05). These results suggest that compared to nucleus pulposus removal, Waveflex system associated with nucleus pulposus excision annulus repair has a more satisfactory effect in the early recovery of lumbar spine function and exerts a positive effect on the stability of the operated segments in the treatment of lumbar protrusion of the intervertebral disc in young adults.

OBJECTIVETo observe the effect of Sam68 gene silencing on proliferation of nasopharyngeal carcinoma (NPC) cell line 5-8F and explore its possible molecular mechanism.

METHODSThe NPC cell line 5-8F was transfected with a small interfering RNA (siRNA) targeting Sam68 and the cell proliferation changes were observed. Quantitative RT-PCR and Western blotting were used to examine the changes in the expressions of Sam68, cell cycle-related proteins, and some up-stream proteins in the transfected cells.

RESULTSTransfection of 5-8F cells with Sam68-specific siRNA significantly lowered the mRNA and proteins levels of Sam68, suppressed cell proliferation, decreased the expression of Cyclin D1, and increased the expression of p27. The transfected cells showed obviously decreased expressions of p-FOXO3a, p-Akt and p-GSK-3β, but the expressions of FOXO3a, Akt and GSK-3β were not obviously affected.

CONCLUSIONSSam68 modulates the proliferation of NPC cells probably by activating Akt/FOXO3a pathway and regulating the cell proliferation-related molecules.

Adaptor Proteins, Signal Transducing ; genetics ; metabolism ; Carcinoma ; Cell Line, Tumor ; Cell Proliferation ; DNA-Binding Proteins ; genetics ; metabolism ; Forkhead Box Protein O3 ; Forkhead Transcription Factors ; metabolism ; Gene Silencing ; Glycogen Synthase Kinase 3 ; metabolism ; Glycogen Synthase Kinase 3 beta ; Humans ; Nasopharyngeal Neoplasms ; genetics ; pathology ; Proto-Oncogene Proteins c-akt ; metabolism ; RNA, Messenger ; genetics ; metabolism ; RNA, Small Interfering ; genetics ; RNA-Binding Proteins ; genetics ; metabolism

OBJECTIVETo investigate the clinical characteristics and prognosis of very young patients with multiple myeloma (MM).

METHODSWe retrospectively analyzed the clinical characteristics and outcome of 35 newly diagnosed MM patients 40 years old or younger during a period of 15 years and compared with published data from western countries.

RESULTSOur study demonstrated that these very young patients were more likely to be in advanced stage of International staging system, IgD isotype, hemoglobin<100 g/L, decreased platelets and deletion of 17p13. With a median follow-up of 17 months (1- 89 months), the median overall survival (OS) of this cohort was 33 months and progression-free survival (PFS) was 13 months, moreover 8 of 17 deaths occurred in the first year after diagnosis. In the univariate analysis, extramedullary infiltration, del (17p13）and renal impairment were associated with reduced PFS (P=0.031, P=0.015, P=000, respectively), while the last two factors also predicted inferior OS (P=0.015, P=0.001), but multivariate analysis showed that only renal impairment independently associated with inferior survival in COX model（PFS: HR=3.953, 95% CI 1.263-12.371, P=0.018; OS: HR=5.769, 95% CI 1.602- 20.771, P=0.007).

CONCLUSIONOur research showed for the first time that the clinical characteristics and survival of MM patients ≤ 40 years old in China were different from that in western countries. The special attention should be paid to the patients with their diagnosis and treatment.

Adult ; China ; epidemiology ; Chromosome Deletion ; Disease-Free Survival ; Humans ; Multiple Myeloma ; diagnosis ; epidemiology ; Prognosis ; Retrospective Studies

OBJECTIVETo study the association between the level of serum DKK1 and disease course of multiple myeloma（MM）as well as myeloma bone disease.

METHODSThis study enrolled 145 cases of MM（including 79 newly diagnosed MM, 19 responded MM, 47 relapsed or progressive MM） whose lytic bone disease were evaluated by conventional radiography, ELISA was used to detect the concentration of serum DKK1.

RESULTSSerum DKK-1 elevated in newly diagnosed MM compared with normal donors［2 155（646-35 251）vs 1 487（646-2 577） ng/L, P=0.000］, those responded［1 136（431- 3 582） ng/L, P=0.001］and relapsed/progressive MM［1 695（431-3 582） ng/L, P=0.037］, and the level of relapsed/progressive MM was marginally higher than the responded ones. Moreover, MM patients without lytic lesions in conventional radiography had significantly lower DKK- 1 levels than those with lytic bone disease［1 910（660-26 925）vs 2 519（646-35 251） ng/L, P=0.005］. Notably serum DKK-1 correlated with the number of bone lesions［0 vs 1-3 vs >3 lesions: 1 910（660-26 925）vs 2 155（1 369-5 974）vs 2 547（646-35 251）ng/L, P=0.018].

CONCLUSIONDKK-1 serum concentration correlated with disease course of MM and myeloma bone disease, indicating that DKK-1 was an important factor for the extent of bone disease, which supporting the hypothesis of DKK-1 as a therapeutic target in myeloma bone disease.

Bone Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Humans ; Multiple Myeloma

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.
Adult ; Asian Continental Ancestry Group ; Biomarkers ; China ; Consensus ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Eosinophils ; Epidemiology ; Epigenomics ; Genetics ; Humans ; Hypersensitivity ; Inflammation ; International Agencies ; Medical Staff ; Neck ; Phenotype ; Precision Medicine