OBJECTIVE: To explore the clinical application value of using needle electrode in transurethral plasmakinetic resection of bladder tumor around ureteral orifice. METHODS: Retrospective analysis was performed on the clinical data of 16 cases who had bladder tumors around ureteral orifice and underwent transurethral resection using plasmakinetic needle electrode in Department of Urology, Peking University International Hospital from June 2015 to December 2019. There were nine cases with the tumor of one to two centimeters from the ureteral orifice. The rest of the seven cases had tumor that was within one centimeter from the ureteral orifice, including two cases whose ureteral orifice was invaded by the tumor. All the patients studied were diagnosed before surgery and contraindications were excluded. The plasmakinetic needle electrode was used to treat the tumor with en bloc resection, and all the excised tissue was sent for pathological examination. Intravesical chemotherapy and postoperative follow-ups were performed. Statistical analysis was performed on the operation time, the incidence of obturator nerve reflex, the peri-operative bleeding, the parameters of indwelling ureteral catheter or double-J stent, the incidence of postoperative hydronephrosis, the clinical stage of tumor, and the recurrence rate. RESULTS: The operation was successfully completed for all the sixteen cases. The operation time was 16 to 57 minutes, with an average of (32.6±11.8) minutes. No obvious obturator nerve reflex and perioperative bleeding occurred in all the patients. Ureteral catheters were indwelled prior to the operation of tumor resection in seven cases. Four of the seven cases had the ureteral catheters remained while the rest three were replaced by double-J stent after surgery. Postoperative pathological analysis showed that all the tumors were urothelial carcinoma, including 9 cases of low grade and 7 cases of high grade. Pathological staging: 10 cases were in Ta stage, 5 cases in T1 stage, and 1 case in T2a stage. All tumor bases and lateral margins were negative. All the patients received 3-56 months, with an average of (26.0±18.1) months of follow-up. There was no case of upper urinary tract hydronephrosis or tumor recurrence. CONCLUSION The transurethral plasmakinetic resection of bladder tumor using needle electrode can realize en bloc tumor resection without obturator nerve reflex and reduce the risk of ureteral orifice injury. It is a safe and effective surgical method for treating bladder tumors around the ureteral orifice.
Carcinoma, Transitional Cell ; Electrodes ; Humans ; Neoplasm Recurrence, Local ; Retrospective Studies ; Urinary Bladder Neoplasms/surgery*

Protein Kinase C (PKC) is an important messenger in intracellular signal transduction. So far, at least 11 members of PKC isoforms have been isolated and purified. The mutation of the non-synonymous SNP (1425G/A) of the η isoform of protein kinase C (PKC η), a protein kinase Cη gene (PRKCH) may result in the increased PKCη activity, which is considered as a new risk factor for lacunar infarction. In recent years, the studies about the role of PRKCH in cell differentiation and apoptosis and its relation with some signal transduction pathways have made some new advances, especially, PKCη participates in the regulation of some key enzyme activity that mitogen-activated protein kinase, inducible nitric oxide-synthase and matrix metalloproteinase are closely correlated with the process of atherosclerosis. It will provide a new way of thinking for the clinical intervention of cerebral infarction in the future.

Objective:To investigate the influence of radiotherapy on immunity of patients with cervical cancer Methods:22 cancer patients and 20 patients with gynecological benign tumor were immunothenotype by flow cytometry Results:There was no obvious difference in immunity between cancer patients and control group After radiopherapy, ratio CD3 +/CD4 + decreased and the number of CD8 + and NK cells increased in cancer patients Conclusion:No immunodepression appeared in patients with cervical cancer before therapy Radiotherapy decreased immunity, which indicates adjuvant immunotherapy should be given during radiotherapy

Objective To evaluate the effectiveness of Inditherm warming system on prevention of intraoperative hypothermia in aged patients with transurethral resection of the prostate(TURP).Methods Fifty two aged patients with benign prostate hyperplasia(BPH) undergoing selective TURP were randomly divided into two groups:observation group(n =27) and control group(n =25).Patients in observation group received temperature prevention from hypothermia by using the patient warming system which temperature was set to 38-40 ℃.The control group were not provided with warming mattress and the ambient temperature of operation room was maintained at 21-23 ℃.The changes of the rectal temperature were continuously monitored during the operation and changes of vital signs,part of postoperative indicators were observed.Results The temperature of patients in both groups decreased after anesthesia.The decreasing degree of rectal temperature at 30,45,60,and 90 min after anesthesia and at the end of operation in observation group was less than those in control group[20min:(36.6±0.4)℃ vs(36.3±0.6)℃,t =2.1362;30 min:(36.4±0.5) ℃ vs(35.8±0.4) ℃,t =4.7536;45 min:(36.2±0.3)℃ vs(35.5±0.5)℃ ;t =6.1751;60 min:(36.1±0.4)℃ vs(35.3±0.4)℃,t =7.2057;90 min:(36.0±0.3)℃ vs(35.3±0.6)℃,t =5.3818;at the end of operation:(36.0±0.4)℃ vs(35.3±0.5) ℃,t =5.5948 ; P ＜ 0.05 or P ＜ 0.01].The occurrence rate of hypothermia(rectal temperature ＜36 ℃) after operation in observation group was lower than that in coutrol group[25.93％(7/27) vs 92.00％(23/25),x2=23.218,P ＜ 0.01];The occurrence rate of shiver was significantly lower in observation group than that in control group[14.81％(4/27) vs 64.00％(16/25),x2 =13.267,P ＜ 0.01].The VAS scores assessment of pain in the observation group was significantly less than that in the control group[(2.45±1.88)points vs(3.79±1.63) points,t =2.7362,P ＜ 0.01].The length of stay was shorten[(5.37±±2.31) d vs (7.13±3.06) d,t =2.3518,P ＜ 0.05]and the prognosis was better in observation group.Conclusion The patient warming mattress can effectively prevent the occurrence of hypothermia of aged patients undergoing TURP and reduce the occurrence of associated complication.

Objective To investigated the efficacy of celecoxib for postoperative analgesia after endoscopic nasal surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes aged 18-64 yr were randomly assigned to one of three groups ( n = 40 each): control group ( group C); celecoxib 200 group ( group CEL1 ) and celecoxib 400 group ( group CEL2 ). The patients took celecoxib 200 and 400 mg by mouth at 1 h before induction of anesthesia in group CEL1 and CEL2 respectively. Anesthesia was induced with midazolam,propofol, remifentanil and rocuronium and maintained with iv propofol and remifentanil infusion. VAS was used to assess postoperative pain (0 = no pain, 10 = worst pain). In PACU when VAS score ≥3, the patients were given fentany125 μg iv every 5-10 min until the VAS score ＜ 3. After being discharged from PACU, the patients received celecoxib 200 mg every 12 h for 5 days in the 2 celecoxib groups. Oxycodone 5 mg was used as rescue analgesic when VAS score ≥ 4 until the VAS score ＜ 4. The number of patients who needed fentanyl for analgesia in PACU, the number of patients who needed oxycodone within 6 h, 6-24 h and day 2-5 after operation and side effects after operation were recorded. Analgesic efficacy was assessed at day 5 after operation and the satisfactory rate of patients calculated. Blood samples were obtained at 0, 6 and 48 h after operation for determination of PGE2,6-k-PGF1α and TXB2 concentrations. TXB2/6-k-PGF1α was calculated. Results The number of patients who needed fentanyl in PACU and the number of patients who needed oxycodone within 6 h and 6-24 h after operation were less, the satisfactory rate was significantly higher, and PGE2 concentrations in blood were significantly lower at 48 h after operation in the 2 celecoxib groups than in group C ( P ＜ 0.05 or 0.01 ). There was no significant difference in each index between the 2 celecoxib groups ( P ＞ 0.05 ). There was no significant difference in TXB2/6-k-PGF1α at each time point among the three groups. Nausea and vomiting occurred in one patient after operation in group C, but side effects were not observed in the 2 celecoxib groups. Conclusion Celecoxib given before and after operation can effectively relieve postoperative pain after endoscopic nasal operation by reducing PGE2 concentrations in blood.

Objective To compare the case-based learning with network with the traditional case-based learning in its effects on clinical practice of internal medicine. Methods Seventy-five in-terns of clinical medicine(5-years programme) and stomatology (7-year programme) of grade 2010 were enrolled, among which forty interns were assigned to the experimental group with the case-based learning with network, feedbacking summary in class after the case of self-study teaching through the network platform and discussion in groups; while the remaining thirty-five interns were provided with the traditional case-based learning as control group. Both groups were assessed with tests of the the-oretical knowledge and clinical skills at the end of their internship in internal medicine. A questionnaire, given to the interns in experimental group, was used to evaluate the teaching effect. The assessment result of both groups was done by t test with the SPSS 16.0 software. Results The total score of the network case teaching group is higher than the ordinary case teaching group. A significant difference of scores in theoretical knowledge and case analysis was witnessed between the two groups (85.2 ±8.7 vs. 80.5 ±9.8, P=0.031 and 87.3 ±6.2 vs. 84.4 ±5.6, P=0.038, respectively). More than 75%interns in the network case teaching group were satisfied with the case-based learning with network. Conclusion The teaching effect the network case teaching is obviously better than the ordinary case teaching . The introduction of the case-based learning with network in clinical practice of inter-nal medicine is beneficial to the implementation of syllabus and students' application of knowledge to clinical analysis. It also helps to improve students' interest and ability of autonomous learning, as well as improve the efficiency of clinical teaching.

Objective To evaluate the effect of intrathecal administration of ?-conopeptide SO3 on inducible nitric oxide synthase(iNOS)expression of spinal cord and the ligated sciatic nerve in a rat model with chronic constriction injury(CCI).Methods 40 male SD rats were randomly divided into 4 groups of 10 animals each.Rats in the N group served as controls;in group C 4 loose ligatures were placed around the right sciatic nerve for 14 days;in group CN,normal saline 1?l/h was injected intrathecally slowly for 7 days seven days after the ligation;in group CS,?-conopeptide SO3 30ng/h was administered intrathecally slowly for 7 days seven days after the ligature.Local expression of iNOS was assayed in samples taken from injured nerves(between and distal to the CCI site)and the spinal cord using Western blotting analysis,with GAPDH as an internal reference.Results A 130 kDa band,corresponding to iNOS protein was detected in the middle and distal sections of the injured nerves and the spinal cord.The iNOS immunoreactivity was inhibited by continuous intrathecal injection of ?-conopeptide SO3.There was no difference in the expression of iNOS between group CN and group C.Conclusion The expression of iNOS in the spinal cord and injured nerves of CCI rats was enhanced.Intrathecal injection of ?-conopeptide SO3 can inhibit the expression of iNOS.The data suggested that N-type calcium channel blocker took part in the expression of iNOS.

Objective To evaluate the clinical effect and safety of homemade biodegradable drug eluting stents(Excel stents)in patients with coronary heart disease.Methods Two hundred and twelve patients who received Excel stents implantation during February,2006 to March 2007 were included in the study.Procedural success rate and complications during hospitalization were monitored and all the patients were followed up clinically up to 8-21 months after discharge.Results The procedural success rate was 99.1%(210/212).A total of 420 Excel stents were implanted while direct stenting was applied in 125 patients(29.8%).Sudden cardiac death happened in 1 patient during hospitalization.Two hundred and six patients finished their clinical follow up and among them,6 patients had recurrant angina.Fifty patients received CAG examination 6-9 months after PCI and 2 patients reached the criteria of restenosis(stenosis ≥50%)and required revascularization.Conclusion Homemade biodegradable drug eluting stents(Excel stents)are safe and effective for PCI in coronary heart disease patients.

Objective To compare traditional arthroscopic reconstruction of anterior cruciate ligament (ACL) and the arthroscopic ACL reconstruction assisted by fluoroscopy-based navigation system in accuracy and reproducibility of the tunnel placement. Methods Fluoroscopy-based navigation system was used in 40 cases of arthroscopic ACL reconstruction from December 2005 to March 2006. Another 40 cases of traditional arthroscopic ACL reconstruction performed between June 2005 and March 2006 were used as control. The positions of the femoral and tibial tunnels were measured on their radiograms and compared statistically. Results The femoral tunnel position measurements averaged 62. 3%?5. 6% (52% - 73% ) in navigation-assisted ACL reconstruction, and 56. 6%?7. 3% (46% - 77% ) in the traditional arthroscopic operation. The tibial tunnel position measurements averaged 45.4%?3. 8% (37%-53% ) in the navigation-assisted ACL reconstruction, and 41. 1%?6. 0% (25% - 54% ) in the traditional arthroscopic operation. The differences were statistically significant ( P

Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Middle Aged ; Neck ; Nose Neoplasms ; pathology ; Rhabdomyosarcoma, Embryonal ; pathology