ObjectiveTo compare the clinical characteristic and postoperative histopathological parameters in different prostate size and to assess the effect of prostate volume on histopathological outcomes in patients after laparoscopic radical prostatectomy. MethodsTwo hundred and sixteen patients from 2006 to 2011 who were proved prostatic carcinoma by biopsy and performed laparoscopic radical prostatectomy wewe retrospectively evaluated.All patients were divided into the small group ( ＜ 30 ml,103 cases),intermediate group(30 -60 ml,71 cases) and large group ( ＞60 ml,42 cases) according to prostate volume.Clinical variables included age,body mass index (BMI),preoperative PSA level,prostate volume,percentage of positive needles,clinical stage,and biopsy Gleason score (GS).Histopathological parameters included pathological GS,upgrading or not compared to biopsy GS,pathological stage and surgical margins status.Preoperative clinical variables and postoperative histopatholgogical parameters were compared among the 3 prostate groups. ResultsPatients with smaller prostates had lower PSA levels than those with intermediate and larger prostates (P =0.000).They also had worse histopathological outcomes such as pathological GS ( P =0.034 ),upgrading of GS ( P =0.037 ),and pathological stage ( P =0.025 ).35.0％ of patients in smaller prostate group had a positive surgical margin compare to 33.8％ and 19.0％ in intermediate and larger prostate groups,but there was no significant difference (P =0.152).ConclusionMen with smaller prostate may have more high-grade cancer and more advanced disease after laparoscopic radical prostatectomy.

Objective To explore the relationship between the change of intestinal environment and pathogenesis of non alcoholic steatohepatitis (NASH). Methods Forty two SD rats were divided into 3 groups randomly: model group( n =24), treatment group( n =12) and normal group( n =6). The rats of model group and treatment group were given fat rich diet, and those of normal group were given normal diet. Furthermore, the rats of treatment group were given lactulose after 8 weeks of fat rich diet feeding. Twelve rats of model group were sacrificed at 8 weeks of study. At 16 weeks, the rats of treatment group, normal group, and the rest of model group were sacrificed. The serum levels of aminotransferase were measured and the pathology of livers were observed by HE stain. Results The rats' livers presented the pathology of steatohepatitis with higher serum levels of ALT and AST in the 16 weeks model group. The serum levels of ALT and AST of treatment group decreased significantly and were close to normal group. The hepatic inflammation scores also decreased markedly (5.83?2.02 vs. 3.63?0.64), but were still higher (3.63?0.64 vs. 1.98 ?0.90) than those of 8 weeks model group. And the degree of hepatocyte steatosis did not change in the treatment group. Conclusions Lactulose could ameliorate the hepatic inflammation of rats with steatohepatitis induced by fat rich diet, but could not prevent the development of steatohepatitis. It suggested the change of intestinal environment, such as intestinal bacteria overgrowth, was one of important factors in the pathogenesis of NASH.

Objective To assess the impact of learning curve on perioperative complications in laparoscopic radical prostatectomy (LRP) by a series of consecutive 200 cases in a single center.Methods Two hundred patients who were biopsy proved prostatic carcinoma and underwent LRP were retrospectively evaluated.All the operations were performed by professor Ma Lulin.The patients were divided into 4 groups according the time of operation.All the clinical data,including age,body mass index (BMI),preoperative PSA level,biopsy Gleason score,and clinical stage were collected.Operative parameters and peri-operative complications were evaluated,including operative time,blood loss,transfusion rate,and perioperative complications.The complications were evaluated by Clavien classification system.Results Age,BMI,PSA,prostate volume,biopsy Gleason score and clinical stage had no significant difference among the 4 groups (P ＞ 0.05).The operative time was gradually lowered from group one to group four.Significantly less blood loss occurred after every 50 cases of LRP (P ＜ 0.001).The complication rates were 15.5％ in this series,28.0％,18.0％,12.0％ and 4.0％ for group one to group four respectively.The complication rate reduced as experience was gained (P =0.008).The rates of mild complications were 24.0％,14.0％,6.0％ and 4.0％,and severe complication rates were 4.0％,4.0％,6.0％ and 0,respectively.Conclusion With experience was gained and technique was improved,the operative time and blood loss of LRP decreased and complication rate reduced substantially.

BACKGROUND:Radiation-induced brain injury has recently become an increasing area of research, in particular in animal experimental studies. Domestic and international researches show that there have been no uniform scanning parameters used for examination of animal models of radiation-induced brain injury by magnetic resonance imaging. In this study, we performed magnetic resonance imaging in rabbits to determine related sequence parameters. OBJECTIVE:To establish the New Zealand rabbit models of radiation-induced brain injury, and obtain the brain magnetic resonance images of rabbits using LOOP7 coil, so as to provide experimental evidence for diagnosis of radiation-induced brain injury by magenetic resonance imaging. METHODS:Each of T2-weighted imaging, diffusion tensor imaging, magnetic resonance spectroscopy and magnetic susceptibility-weighted imaging were performed several times through the use of LOOP7 coil, to determine the optimal scanning parameters for each sequence. Rabbit models of radiation-induced brain injury were established and then their right hemispheres were irradiated using 6 MV X-rays at a single dose of 40, 80 and 120 Gy. The daily performance and dynamic magnetic resonance signs of rabbits were observed. The brain tissue was taken for pathological examination once abnormal magnetic resonance findings were observed or after 20 weeks of folow-up. RESULTS AND CONCLUSION:Only one rabbit model in the 40 Gy group had subdural hemorrhage. In the 80 Gy group, abnormal T2-weight imaging signals were observed in al rabbit models, which were pathologicaly confirmed as scattered degenerated neurons and infiltrated neutrophils. The abnormal signals that gradualy expanded over time were seen in rabbits from the 120 Gy group by magnetic resonance imaging and were pathologicaly confirmed as radiation-induced brain injury loci. The results confirm that establishing rat models of radiation-induced brain injury using radiation therapy system can better simulate the pathological process of radiation-induced brain injury; moreover, this model can be applied to receive routine magnetic resonance examination with LOOP7 coil.

Objective To understand the relationship between age and chronic complications in hospitalized aged patients with hypertension, to provide evidence for hypertension prevention and control. Methods To retrospectively analyze the clinical and laboratory data on 17,682 patients with essential hypertension during Jan 1st,1993-Dee 12th, 2008 in PLA general hospital. Results 1)Among all of the inrolled cases, those aged 60-64 account for 27.87%, 65-69 years group account for 26.55%, 70-74 years group accounted for 23.96%, 75-79 years group accounted for 14.14%, 80-84 years group accounted for 5.26%, 85-89 years group accounted for 1.69%, > 90 years accounted for 0.41%. 2) The prevalence rate of chronic complications in 60-69 years group were 31.3-31.2% for diabetes and,22.6-27.0% for cerebrovascular disease, 9.5-11.1% for myocardial infarction, 6.7-9.1% for heart failure, 5.8-6.0% for renal dysfanction 4.9-6.8% for atrial fibrillation, 0.1-0.3% for multiple organ dysfunction syndrome (MODS) in the elderly(P <0.05 ). 3) The first four complications of hypertension were diabetes(33.5%), cerebrovascular disease (31.9%), myocardial infarction(13.2%) and heart failure(12.3%) in 70-74 years group (P<0.05), cerebrovascular disease (42.8%), diabetes (32.8%), heart failure (16.5%) and myocardial infarction(15.9%) in 75-79 years group (P<0.05), cerebrovascular disease (45.4%), diabetes (35.0%), heart failure (21.1%) and myocardial infarction(15.9%) in 80-84 years group (P<0.05), cerebrovascular disease(42.5%), diabetes (35.8%), heart failure (23.1%) and renal dysfanction (17.7%) in 85-89 years group(P<0.05 ),and cerebrovascular disease (45. 2%), heart failure(31.5%), diabetes (26.0%) and renal dysfanction (20.5%) in patients more than 90 years group (P<0.05). Conclusions The prevalence rate and kinds of chronic complications in hospitalized aged patients with hypertension were changed with the increasing age, and the first kind of complication is cerebrovascular disease. It is of more importance to prevent the occurrence of renal dysfanction and heart failure in those hypertension patients who were more than 80 years old.

Objective To evaluate the nasointestinal decompression intubation in acute small intestinal obstruction. Methods Ten patients with acute small bowel obstruction received nasointestinal decompression intubation under x-ray guidance. The nasointestinal decompression tube passing over a guidewire was inserted into small intestine near Tres ligament or further down distally with assistance of patients adopting in multi-physical positions. Results The intubation of nasointestinal decompression tubes into small intestine was technically successful in all patients with average procedural time of 16 min.(10 ～ 35 min). After placement of the tube, all patients obtained various degrees of symptoms relief including abdominal pain, distention, vomiting, etc. Four patients with simple adhesive obstruction recovered completely and the tube was removed 2 weeks later. Three patients were refered to surgical operation, and 3 others gave up for further treatment. There were no complications such as bleeding or perforation related to intubation. Conclusion Nasointestinal decompression intubation under guidance of X-ray is rather simple, less time consuming, especially with high efficiency for preoperative gastrointestinal decompression and treating simple adhesive bowel obstruction; ought to be recommended. [

Objective To provide theoretical basis for clinical treatment of all-ceramic crown prosthodontics,the influence of cement thickness on the stress distribution in all-ceramic crowns under load was studied numerically.Methods The finite element analysis(FEA) model of a standard mandibular first molar was established using spiral CT and CAD software,and then it was applied to analyze the stress distribution of all-ceramic crowns under vertical loading using FEA software.Results Stress concentration was found in mesial and distal cement;the stress distribution at the cement upper and lower interface was found to be similar,and the stress magnitude discrepancy between the two interfaces was small;the stress of the model with 0.15 mm cement in the cervix was lower about 30% than the one of the 0.05 mm model.Conclusions The cement thickness plays an important role in the stress distribution of all-ceramic restoration system.The model with 0.15 mm cement shows a better resistance to destruction among the three models investigated.

Objective:To observe the risk factors of acute renal injury(AKI) after coronary artery bypass grafting(CABG) and the influence of blood pressure on AKI.Methods:980 patients in CABG of Cardiology Department of TEDA International Cardiovascular Hospital were diagnosed with AKI according to the AKIN standard, with 706 males and 274 females, averaged(61.9±8.0)years old. Patients were divided into two groups according to whether AKI occurred: AKI group(86 cases) and non AKI group(894 cases). The baseline clinical data, operation related data were compared between the two groups. At the same time, according to the preoperative mean systolic blood pressure(SBP) level, LSP[mean systolic blood pressure<120 mmHg(1 mmHg=0.133 kPa), 374 cases], MSP(mean systolic blood pressure 120-140 mmHg, 481 cases) and HSP(mean systolic blood pressure≥140 mmHg, 125 cases) were classified as covariates, and the influencing factors of dependent variable AKI were analyzed by multivariate logistic regression.Results:The prevalence of AKI was 8.7%(86/980). Compared with non-AKI group, preoperative SBP[(129.8±13.8)mmHg vs.(124.4±13.3)mmHg, P=0.000], mean arterial pressure[(91.9±8.8)mmHg vs.(88.8±9.1)mmHg, P=0.004], and mean pulse pressure[(56.9±10.7)mmHg vs.(53.2±9.8)mmHg, P=0.001]were increased significantly. After adjusted for other risk factors, preoperative SBP elevation, hypertension history, cardiopulmonary bypass(CPB), use of intra-aortic-balloon-pump(IABP), secondary thoracotomy, preoperative diuresis, intraoperative blood transfusion and baseline low glomerular filtration rate(eGFR) were independent risk factors for AKI after CABG. Compared with LSP group, the relative risk of AKI after CABG in HSP group was 2.743(95% CI: 1.595-4.715). In patients with hypertension history, AKI in HSP group was significantly higher than that in LSP group(18.4% vs. 8.1%, P=0.001). However, the preoperative blood pressure level of patients who denied the history of hypertension had no effect on AKI. Conclusion:Preoperative SBP is a risk factor for AKI after CABG. The incidence of AKI after CABG can be significantly reduced by controlling SBP below 140 mmHg in patients with hypertension.

Background and purpose:We investigated whether lfuorine-18 lfuorodeoxyglucose (18F-FDG) maximal standard uptake value (SUVmax) of the primary tumor (SUV-T), SUVmax of the regional lymph nodes (SUV-N) or the overall loco-regional lesion SUVmax (SUV-TOTAL) was related to survival of patients with stage Ⅲ non-small cell lung cancer (NSCLC) who received Cetuximab and combined definitive chemoradiotherpay. Methods:From September 2009 to July 2012, seventeen patients with unresectable stageⅢNSCLC receiving cetuximab with cisplatin/vinorelbine (NP) followed by concomitant NP and intensity-modulated radiotherapy (IMRT) at the Fudan University Shanghai Cancer Center were enrolled onto a prospectively study. All patients received positron emission tomography/computerized tomography (PET/CT) scans within 2 weeks before enrolment. Univariate analysis were used to assess the correlation between SUV-T, SUV-N, SUV-TOTAL, gender, age, histology, tumour-node-metastasis (TNM) stage, performance status (PS) as well as smoking status and survival. The factors which showed statistical signiifcance entered into multivariate Cox-regression model. Survival functions of different populations were estimated by Kaplan-Meier method and compared by Log-rank test. Results:In the univariate analysis, SUV-T, SUV-N, SUV-TOTAL, PS and smoking status were prognostic factors. The best cut-off values for SUV-T, SUV-N and SUV-TOTAL were 11, 11 and 20, respectively. Multivariate analysis revealed that SUV-TOTAL (P=0.012), SUV-T (P=0.025), and SUV-N (P=0.033) were independent predictors of survival with hazard ratio (HR) of 14.7, 11.2, and 6.2, respectively. Conclusion:Local, regional and locoregional maximal SUVs deifned by 18F-FDG PET-CT scanning may have a strong correlation with survival in this patients setting, which merits further study.

ObjectiveTo evaluate the value of MRI diffusion weighted imaging in localization of prostate cancer with whole-mount step section pathology.MethodsWe treated 36 patients using laparoscopic radical prostatectomy from Oct. 2009 to Jun. 2010. Patients who did not have an MRI/DWI examination or a surgical history of prostate and previous hormonal therapy were excluded, leaving 19 patients in our study. We analyzed the MRI and DWI collected before radical prostetectomy surgey and the post-surgery step section pathology made by the whole mount technique. The prostatic gland was divided into six sections. Two doctors read the MRI/DWI without knowing the patients' information and scored, using a 5 point scale, for each section. The tissue was graded according to the following scale: 1-definitely no cancer, 2-probably no cancer, 3-possible cancer, 4-probable cancer and 5-definite cancer. When the average score ≥4 the region was assumed to be the prostate cancer region by MRI or MRI/DWI.ResultsIn 19 patients with 114 regions, there were 48 (42％) prostate cancer regions approved by whole-mount step section pathologically.The number of prostate cancer regions was 15 (39％), 21 (55％) and 12 (32％) in base, mid and apex parts respectively. The sensitivity and specificity of the MRI was 62.5％ and 69.7％. When considering DWI, the specificity and sensitivity was elevated to 79.1％ and 83.3％. As for the apex and mid parts, the sensitivities of MRI were a little bit low (46.7％ and 66.7％ ). But the sensitivities of localization of prostate cancer for the apex and mid of prostate were elevate to 73.3％ and 85.7％ respectively when DWI was also used.ConclusionsWith whole-mount step-section pathology, the combination of MRI and DWI can improve the sensitivity of MRI for localized diagnosis in prostate cancer, especially in apex and mid parts of the prostate.