Objective To investigate the clinical and pathological characteristics of urocpithelial sarcomatoid carcinoma of the urinary system,and improve the diagnosis and treatment of these tumors.Methods We reviewed the pathology comfirmed urinary system caicinoma at the General Hospital of PLA from January 1999 to December 2010 and analyzed the clinical and pathological data of cases with sarcomatoid carcinoma in them retrospectively according to the literatures. Results A total of 4386 urinary system carcinoma were comfirmed,among them 18 (0.41％) cases of sarcomatoid carcinoma were identified,including 13 from bladder,4 from ureter and 1 multiple neoplasm of pelvis and ureter.The patients,11 males and 7 female,had a median age of 63.3 years (41-84 yrs).Gross hematuria (18 cases) were the main presenting symptoms,3 with flank pain,4 with pollakisuria,urgency and dysuria (urinary irritation symptoms] and 5 with urinary obstruction.The patient with multiple neoplasm of pelvis and ureter received allograft renal transplantation 7 years ago and took anti-rejection drugs all the way after operation.17 patients underwent surgical resection,9 radical cystectomy,5 radical nephroureterectomy,3 partial cystectomy and the remain was biopsy.Tumor size ranged from 2.5 to 12 cm (median,5.6 cm).Microscopically,coexisting high grade urothelial carcinoma was present in all the 18 cases,12 with sarcomatoid differentiation,3 with sarcomatoid and squamous carcinoma differentiation and 3 with sarcomatoid and glandular differentiation.Sarcomatoid component occupied 10 -90 percent.Immunohistochemical testing showed the sarcomatoid cells were positive for cytokeratin (CK) and vimentin.12 patients died of disease 20 days to 42 months (median,5.3 months) postoperatively.3 patients have been surviving with tumor free for 3,3 and 17 months respectinely,and the other 3 was failure to be followed. Conclusions Sarcomatoid carcinoma of the urinary bladder is a highly malignant disease,and the prognosis is very poor.The diagnosis depends on histopathologic and immunohistochemical studies.Early diagnosis and cystectomy or nephroureterectomy together with chemotherapy/radiotherapy may improve the curative effect.

Recent studies have shown that Notch signaling pathway can improve neural stem cell selfrepair ability and promote angiogenesis,but at the same time,it will also aggravate the inflammatory response after cerebral ischemia.This article reviews the relationship between Notch signaling pathway and cerebral

OBJECTIVE:To establish a method for simultaneous determination of the contents of three components in synthesis and actual satongfeng injection.METHODS:A flexible tolerance simplex method was used for multi-wavelength spectrophotometry with interval of 1nm in 258～290nm wavelenth,33 wavelenths were selected.RESULTS:The linear range and average recoveries rate of sodium salicylate,phenazone and caffeine were 0～42,0～12,0～6?g?mL-1 and(99.93?0.22)%,(99.85?0.24)% and(100.19?0.40)% respectively.All were agreed with those by standard method.CONCLUSIONS:This method is easy in operation,fast and reproducible,applicable to automatic analysis,and therefore can be used for the quality control of the preparation.

The effects of minimally invasive surgery on the blood-brain barrier (BBB) of 30 patients with cerebral hemorrhage were investigated. Difference of the BBB index and serum MBP concentration were assessed in 15 cases of conservative treatment group and 15 cases of minimally invasive surgery group. The BBB index in minimally invasive surgery group was significantly lower than in conservative treatment group (P<0.05), and the BBB index in the two treatment groups was significantly higher than in control group (P<0.01). Serum MBP concentration in minimally invasive surgery group was significantly lower than in conservative treatment group (P<0.05), and that in the two treatment groups was significantly higher than in control group (P<0.01). It was suggested the permeability of BBB in patients with cerebral hemorrhage was increased, and BBB index and serum MBP concentration in patients with cerebral hemorrhage were increased. Minimally invasive surgery can reduce the lesion of cytotoxicity to BBB and cerebral edema.

BACKGROUND: The effect of cognitive therapy on psychological stress is not remarkable and optimal. Some psychocatharsis through physical activities cannot be accepted by many clients.OBJECTIVE: To explore an effective method to treat and relieve psychological stress.DESIGN: A controlled (the blank control and the self-control) observation study and single blind trial.SETTING: Department of Preventive Medicine, Medical College of Jinagsu University.PARTICIPANTS: Clients who suffered from emotional suppression or nervous stress would be tested with "psychological stress test". Forty clients, with scores over 5, were selected as the subjects. They were randomly divided into two groups matching of ages and scores: control group (n=20) and experimental group (n=20).METHODS: Clients in the control group were treated with common cognitive therapy by means of talking, and those in the experimental group accepted a sing a song loudly therapy. The song named as Qinghai-Tibet Plateau was selected for the treatment. The clients were requested to sing the song loudly in order to release their stress and vent their repression.The psychologist used the language introduction by background music to make a client under a special kind of psychological situation and emotional state when the music was played for one to two times. Then the psychologist would turn up gradually the volume of sound to the maximum when the music was played for the third time. The volume from the VCD would overwhelm that from the client's voice in order to cover up the singer's shyness. The client sung the song of Qinghai-Tibet Plateau loudly for four to five times. The therapeutic room was required to have a blanch curtain.The sound insulation also was required. The soundscape of the loudspeakers should be wide. The power magnifier should be strong. The loudspeaker should be high fidelity. The questionnaire of psychological stress test was adopted in both groups before and after therapy respectively. It had 30 items for the self-diagnosis of symptoms. The client was diagnosed as a low stress if his or her score reached 5, 11-20 as sever stress, and above 21 as adaptability disorder.MAIN OUTCOME MEASURES: Scores of stress level were observed before and after therapy in both groups.RESULTS: The scores in the control group before and after therapy were approximately the same (15.6±5.3 vs 14.7±4.8, t=1.739, P ＞ 0.05). The scores in the experimental group after therapy was significantly lower than those before therapy (11.6±5.8 vs 15.5±6.1, t=9.863, P ＜ 0.05). After therapy, the scores in the experimental group were significantly lower than those in the control group (11.6±5.8 vs 14.7±4.8, t=4.811, P ＜ 0.05).CONCLUSION: Sing a song loudly is an effective method that is easy to operate in treating psychological stress.

The effect of low dose radiation on tumor metastasis in mice was investigated by using the models of B16 melanoma bloodtract pulmonary metastasis and Lewis lung carcinoma. The results were reported as follows: (1) The number of B16 melanoma pulmonary metastatic colonies of the mice pre-received different doses(25,50,75,100mGy) of whole body irradiation were lower than that of unirradiated control group mice (P

Objective To know the influence of preoperative respiratory function exercise on the postoperative pulmonary function among patients with lung cancer. Methods Divided 80 patients with lung cancer into the observation group and the control group, there were 40 cases in the each group. Routine perioperative nursing cares was used in the control group, while a two weeks respiratory function exercise was used in the observation group. Compared the incidence rate of complications be-tween the two groups after the intervention, some indexes which can indicate the respiratory function were compared before and after the exercise in the observation group. Results The indexes such as PaO_2, SpO_2, MVV, TCL and FEV in the observation group after the respiratory function exercise were better than before significantly. The incidence rate of complications in the control group was more than in the observa-tion group. Conclusions Strengthen respiratory function exercise can effective improve the respiratory func-tion for patients with lung cancer when cured by thoractomy, which can promote patients' compliance, and then avoid certain postoperative complications.

Skillful in the treatment of gouty arthritis (GA) by integrated therapies of Chinese and Western medicine,chief physician Zhang Tang-fa proposes to ‘deal with the exterior with the needles,and attack the interior with the drugs,by integrated application of acupuncture and herbal medicine',in combination with comprehensive intervention of dietetic therapy and health education.In the treatment of GA,he adopts the syndrome differentiation based upon the pathogenic factors,in combination of syndrome differentiation based upon the six meridians,to reinforce and benefit the spleen and kidney,clear away heat and remove dampness as the therapeutic principle.By acupuncture mainly at the acupoints of the Spleen and Liver Meridians,he also proposes to select the acupoints by the theory of Na Zi Fa (earthly branch method) of Zi Wu Liu Zhu (midnight-noon ebb-flow),and to puncture the surrounding area of the involved joints shallowly by multiple needles as the major needling method,simultaneously with the reinforcing and reducing manipulations based upon the respiration.In the treatment,acupuncture and acupoint-injection are often used.In diet,low purine diet is often suggested.In health education,the patients are often instructed to understand the disease correctly,eliminate fears and cooperate with doctor's treatment positively.

Objective To discuss the pathogenesis,diagnosis and treatment of delayed traumatic intracerebral hematoma.Methods The clinic data of traumatic delayed intracranial hematoma patients in this hospital were retro- spectively analyzed.According to clinic observation and CT re-examination,47 cases were diagnosed as delayed trau- matic intracranial hematoma(45 cases by operative treatment,and the other 2 by conservative treatment).Results There were 21 cases of recovery,10 cases of slight disability,8 cases of severe disability,8 cases of death.The total mortality rate was 17 %.Conclusion Brain contusion,subarachnoid hemorrhage and skull base fracture were impor- tant factors of DTICH.Fine-observation and prompt CT re-examination offered excellent results for DTICH.

Objective To evaluate the therapeutic and adverse effects of metallic intratracheal stent placement in relapsing polychondritis with severe tracheobronchial malacia.Methods Five tracheal stents had been implanted in three patients with traeheobronchial malacia.One patient was implanted with two tubular steuts in trachea and one“Y”shaped stent for bilateral bronchi.Another patient used a tubular stent in total tracheal segment.The last patient used a tubular stent in the upper segment of trachea.Results All the stents were implanted successfully with obvious improvement of dyspnea after the treatment. Conclusions Metallic intratracheal stent placement can really relieve symptoms and improve the life quality in patients with tracheobronchial malacia caused by relapsing polychondritis.