Objective:To retrospectively evaluate the prognostic risk factors of patients with gallbladder carcinoma and the effect of normal prognostic nutrition index (PNI) on the survival. Methods:We retrospectively analyzed 63 patients with gallbladder carcino-ma treated in our hospital between January 2008 and December 2012. The independent prognostic factors of the patients were calculat-ed by the Cox proportional hazards model. The benefit of normal PNI status on the prognosis was further explored in the patients using survival analysis. Results:Lymph node metastasis, PNI≤50, squamous carcinoma, liver invasion and choledoch invasion were the risk factors of overall survival (OS) in the univariate analysis, while only lymph node metastasis (HR=4.495, 95%CI 2.380~8.488, P<0.001) and PNI(HR=0.195, 95%CI 0.098~0.389, P<0.001) were the dependent influential factors of the prognosis and OS in the multi-variate analysis. The effect of PNI on OS was even more statistically significant different in the younger patients (≤65y) than in the el-der (>65y) (younger group:P=0.011;elder group:P=0.078). Conclusion:The gallbladder carcinoma patients with normal PNI status (>50) have better OS compared to the patients with PNI≤50, with statistical differences between the two. And it is more significant in the patients of the younger group (≤65y), comparing with the elder group. PNI could be taken as a potential prognostic evaluation factor for the gallbladder carcinoma patients and can provide a more comprehensive evaluation of patients' conditions to clinician.

Objective To compare the therapeutic effect of laparoscopic radical cystectomy with orthotopic ileal neobladder (LRC-INB) vs open radical cystectomy (ORC-INB). Methods A total of 81 patients were evaluated including 33 undergoing LRC-INB (group A) and 48,ORC-INB (group B) from June 1994 to September 2004 at our institution.The parameters for analysis included operative time,surgical method,blood loss,therapeutic effect,complications and hospital stay.Statistics included t-test and chi-square analysis (P

Objective To investigate the feasibility of construction of orthotopic ileal neobladder after laparoscopic radical cystectomy(LRC)for female patients with bladder carcinoma.Methods From February 2003 to July 2006,we had performed construction of orthotopic ileal neobladder after laparoscopic radical cystectomy,hysterectomy,and ovariectomy on 8 women with bladder carcinoma.Under general anaesthesia,the patients were placed in the supine position with the head down at 15?,the thighs abduced,and the knee flexed.A 5-port transperitoneal approach was used.Under a laparoscope,the peritoneum was incised at the level of the bifurcation of the iliac vessels,and then the ureter was freed,and the round ligament of the uterus and the ovarian ligament were cut.Afterwards,the broad ligament was separated and pelvic lymphadenectomy was done.Then,the cardinal and uterosacral ligaments,bilateral ureters,and the lateral pedicles of the bladder were cut;the peritoneum was incised along the base of the broad ligament to open the vaginal vault so that the peritoneal reflection can be transected to expose the retropubic space.After that,the deep dorsal vein of the clitoris and the ureter was cut successively(the ureter was cut at 0.5 cm downwards from the neck of the bladder.Finally,the vagina was transected at the level adjacent to the vaginal vault,and the residual vagina was sutured.After the laparoscopy,the resected tissues were removed through a 4-to 5-cm incision on the midline of the lower abdomen,and then a M-shape ileal neobladder was constructed outside the incision.The ureter was reimplanted to the posterior wall of the pouch and replaced into the peritoneal cavity.The urethra-pouch anastomosis was completed by laparoscopy.Results The mean operation time in the 8 patients was(344.5?42.1)min,mean blood loss was(373.9?81.3)ml.The patients were followed up for 6 to 46 months with a mean of 26 months(over 12 months in 6 patients).During the follow-up,all the patients achieved automatic micturition in half a year.One patient had urinary incontinence occasionally,one had night-time urinary incontinence,and one had dysuria.The mean volume of the neobladders was(333.6?40.4)ml,and residual urine volume was(51.2?18.1)ml.After the operation,one patient developed uretero-neobladder anastomotic occlusion,and one had fistula of the neobladder.Conclusions Laparoscopic radical cystectomy,hysterectomy,and ovariectomy is feasible for female patients with bladder carcinoma.After the procedure,which is mini-invasive,most patients had automatic micturition;however,the rates of urinary incontinence and dysuria are relatively high.Further investigations are needed to study the long-term outcomes of LRC and reconstruction of orthotopic ileal neobladder.

Objective To study expression and clinical significance of nm23 genes in primary breast carcinomas. Methods The expression of nm23 was detected by immunohistochemical S-P method in 286 cases of primary breast carcinomas. Results The positive rate of nm23 expression was 65.7%. There was not a significant correlation between the positive rate of nm23 and patients' age, tumor pathological types. There was a significant relation between the expression of nm23 and tumor clinical stage, axillary lymph node metastasis, and the positive rate of nm23 expression in the cases of clinical stage I without axilliary lymph node metastasis was significantly higher than that in the cases of clinical stage III with axilliary lymph node metastasis. Conclusion The expression of nm23 gene was negatively related with clinical stage and axilliary lymph node metastasis in breast carcinomas, which indicated that nm23 gene expression may serve as an index for predicting lymph node metastasis and the prognosis of breast carcinoma.

Objective To understand the effect of circumcision in reducing high-risk human papilloma virus (HPV) infection in male adults. Methods One hundred and twenty-eight married adults with phimosis who underwent circumcision enrolled in the case group and high-risk HPV of urethral discharge specimens were detected before and 2 years after operation. A total of 128 cases of phimosis without circumcision were recruited in the control group. High-risk HPV infection rates were compared between the two groups. Results The highrisk HPV infection rates in the two groups were comparable at baseline. In the circumcision group, high-risk HPV infection rate was 27. 3% preoperative and it significantly decreased to 12.5% two years after operation( x2 =8. 839 ,P =0. 005). In the control group,high risk HPV infection rate was 28. 1% at baseline and it was 25.0%two years later, with no significant difference (x2 =0.320,P = 0.671).Conclusion Circumcision can significantly reduce high-risk HPV infection. Promoting circumcision actively in our country may have an important role in preventing high-risk HPV infection.

Objective To investigate the cavernous nerves innervation from prostate apex to glans penis and the relation between cavernous nerves and surrounding tissues and organs. Methods The urethra and penises of three formalin preserved adult cadavers were removed from prostate apex to glans penis.The sections underwent hematoxylin-eosin staining and Bielschowsky nerve staining.The course and distribution of cavernous nerves and relationship between the cavernous nerves and surrounding tissues and organs was observed microscopically and photographed from prostate apex to glans penis. Results From serial sections we found when nerve fibres run along prostate apex,while surrounding the lateral and dorsal aspects of prostate apex and urethra.from 30'clock to 9 0'clock.Most fibres went through smooth muscle and some of them went through the periphery striated muscle and urogenital diaphragm.The distance to urethra lumen was only 3-5 mm.After the nerve fibres went distally and anteriorly,they accompanied closely with cavernous vein plexus and then went into corpora cavernosa.At the distal end of corpora cavernosa,there were"windows"through which the neurovascular bundles communicated between corpora cavernosa and glans penis just like doors to glans penis. Conclusions When nerve fibres run from prostate apex to urogenital diaphragm,along dorsal lateral aspect of prostate and urethra,there are only 3-5 mm to the urethra lumen,so it is very easy to be injured in traumas or operations.In the urethral bulb fragment,the nerves run anteriorly and laterally.out of the periphary muscle,so the cavernous nerves will not be i~ured when dissect urethra bulb from surrounding muscles.Dissect glans penis from distal end of penis in operation would be avoided in order to protect the cavernous nerves between corpora cavernosa and glans penis.

Objective To describe the cloning of cDNA of prostate specific membrane antigen (PSMA),construction of the recon of PSMA,induction of the expression of 6 ? His PSMA fusion protein from PSMS recon,and purification of the expression products. Methods The total RNA was extracted from prostate cancer tissues.The site of EcoR I lying in the middle of PSMA’s cDNA was used to perform the reverse transcriptase and polymerase chain reaction of PSMA in two different parts,which were then linked into the carrier of pEt 30(a),thus the full cDNA of PSMA and the pronucleus expression carrier pET 30(a) PSMA were obtained.The pET30a (+) PSMA recon was transformed into the Escherichia coli BL 21 and the engineering bacteria expressing protein PSMA was gotten. With the induction of IPTG, the recon was expressed. The expression products were purified with Ni NTA Agarose resin, then the purer protein PSMA was obtained. The antigenicity and specificity of the expressed PSMA were evaluated with Western blotting and SDS PAGE. Results The wholly right base sequence of PSMA’s cDNA was successfully cloned.PSMA protein was expressed and purified.This protein had better antigenicity and specificity. Conclusions This study provides experimental basis for the function study of PSMA and scanning of the phage antibody library.

BACKGROUND: The commonly used culture methods for primary intervertebral disc cells are type Ⅱcol agenase alone digestion method, and type Ⅱ col agenase combined trypin digestion method. However, the acquired cells are few. OBJECTIVE: To acquire nucleus pulposus cells from human degenerative intervertebral disc using a systemic and simplified method. METHODS: Nucleus pulposus cells were isolated and cultured. The morphology of nucleus pulposus cells was observed under inverted phase contrast microscope every day. Primary and subcultured cellsuspension was applied for the determination of cel viability using trypan blue staining. The cel growth was detected with MTT assay. The cel morphology was observed under laser confocal microscopy. RESULTS AND CONCLUSION: Nucleus pulposus cells were successful y isolated from from human degenerative intervertebral disc using the improved method, and cells were subcultured to passage 3. Primary cells were fusiform shaped, while cells at passage 1 and 2 were triangle or polygonal, which were similar to fibroblasts. When cells almost reached the confluence, the cells showed slabstone-like appearance. Trypan blue staining showed that, the primary cel viability was 99%, and passage 3 cells had 93%-95% viability. The proliferation of nucleus pulposus cells gradual y decreased as the generation increased. Compared with passage 1 cells, passage 2 and 3 cells at logarithmic phase trended to be smoother. The cel morphology observed under laser confocal microscopy was similar to the results under phase contrast microscope. The improved simple method can successful y acquire a variety of cells from human degenerative intervertebral disc, and these cells show fine biological properties.

OBJECTIVETo explore the effect of Shenxiong Huayu Capsule (SHC) on the cerebral ischemia-reperfusion (IR) injury and the expression of growth associated protein 43 (GAP43) after total cerebral IR in the hippocampal CA1 region of rats.

METHODSTotally 100 male adult SD rats were randomly divided into five groups, i.e., the control group, the model group, the group A (by taking SHC once daily), the group B (by taking SHC twice daily), and the group C (by taking SHC thrice daily), 20 in each group. The total IR model was prepared by improved Pulsinelli's 4-vessel occlusion method. Morphological changes of the hippocampal CA1 region were observed by HE staining at day 1, 3, 7, and 14. The expression of GAP43 in the hippocampal CA1 region was detected using immunohistochemical assay at day 1, 3, 7, and 14. Meanwhile, the behavioral score was determined. The expression of GAP43 in the hippocampal CA1 region was detected using Western blot at day 14.

RESULTSCompared with the control group, the expression of GAP43 increased in the model group, the behavioral score was elevated, degenerated neurons increased, and survival neurons decreased in the model group (all P < 0.05). Compared with the model group, the expression of GAP-43 increased (with the most significant difference seen in the group C, P < 0.01), the behavioral score significantly decreased, degenerated neurons decreased, and survival neurons increased in each HSC group (all P < 0.05). Survival neurons obviously increased at day 14, of which, most number of survival neurons and highest contents of GAP43 protein could be seen in the group C, showing statistical difference when compared with those of the group A and the group B (P < 0.01).

CONCLUSIONSHC had protective effect on total cerebral IR in the hippocampal CA1, which might be associated with increased expression of GAP43.

Animals ; Brain Ischemia ; metabolism ; CA1 Region, Hippocampal ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; GAP-43 Protein ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism

ObjectiveTo assess the safety and efficacy of retrograde ureteroscopy lithotomy (URSL)assisted antegrade percutaneous nephrolithotomy (PCNL) for complex upper ureteral calculi in semisupine-lithotomy position.MethodsFrom March 2007 to December 2010,a total of 95 patients with complex upper ureteral calculi underwent retrograde URSL assisted antegrade PCNL in semisupine-lithotomy position.Ureteral calculi size was 12 mm × 6 mm to 38 mm × 15 mm,24 cases combined with renal calculus.Firstly retrograde URSL was performed,once the stone fragments moved up to renal pelvis,a 16-22 F PCNL working channel was established under the ultrasound guidance through which lithotripsy was performed using an ureteroscope.Finally a 6-7 F double-J tube was indwelled.ResultsOperations were successfullycompleted in 93 patients.However,in it 2 patients were converted to open surgery because of significantureteral distortion due to previous open surgery.Operative time was(42.7 ± 14.9) min; estimated blood loss was(34.5 ± 26.1 ) ml.The ureteral calculi clearance rate was 100.0％,and renal calculus clearance rate inthose combined with renal calculus was 95.8％ (23/24).There were no major intraoperative and postoperative complications excepted early urinary leakage in 2 cases and fever ≥39℃ in 3 cases.ConclusionsRetrograde URSL assisted antegrade PCNL in semisupine-lithotomy position is safe and feasible for complex upperureteral calculi,especially non-opaque calculi,combined with renal calculus,easily ascending ureteral calculi and large calculi burden which has low calculi clearance rate after URSL.The outcomes are encouraging with fewer complications.It also avoids intraoperative change of patient's position.