Objective To determine relative risk factors for positive surgical margins in extraperitoneal laparoscopic radical prostatectomy(LRP). Methods From February 2004 to September 2007,33 patients(mean age 70 years old)with prostate cancers underwent extraperitoneal LRP.All patients were diagnosed by pathology preoperatively.Gleason score:3+3 14 cases(43%),3+4 11 cases(33%),4+3 6 cases(18%),4+4 2 cases(6%).Clinical stage:T1a-T1b 4 cases(12%),T1c 14 cases(43%),T2a-T2b 5 cases(15%),T2c10 cases(30%).Logistic regression analyses were performed. Results LRP was successfully performed on 31 cases.There were 2 cases converted to open surgery.Nine cases(27%)had PSMs.There were 6 cases(67%)and 4 cases(17%)of clinical stage T2c in PSM and negative surgical margin(NSM)groups respectively(P=0.010).There were 3 cases(33%)and 0(0)with high Gleason score(higher than 7)in PSM and NSM cases(P=0.015).There were 4 cases(44%)and 5 cases(21%)with t-PSA higher than 20dg/ml in PSM and NSM cases respectively(P=0.178).In these 9 cases,there were 4 cases(44%)positive with DRE.However there were 9 in the 24 NSM cases(38%)(P=0.509).Clinical stage T2c was independently positively correlated with PSM(OR=24.69).High Gleason score(higher than 7)and t-PSA higher than 20 ng/ml were positively correlated with PSM. Conclusions Clinical stage is positively correlated with PSM.It is an independent factor.High Gleason score(higher than 7)and t-PSA higher than 20 ng/ml mignt be the risk factors in predicting PSM and should be used together with clinical stage.Positive DRE findings may be also useful to predict PSM.

Objective To study the state and trends of Kesan disease in Henan province from 2004 to 2009. Methods Surveillance sites were selected: Guxian village of Luoning country from 2004 - 2007, Zuyang town of Lingbao city in 2008, and Shahe village of Lushi country in 2009. All residents of surveillance sites were examined by clinical and electrocardiogram, and suspected patients were inspected by chest X-ray to measure ardiothoracic ratio. Hair and wheat flour samples were collected and selenium levels were detected with hydride generation atomic fluorescence spectrometry. Results From 2004 to 2009, a total of 4034 people were examined.The numbers of chronic and latent KSD patients were 21 and 75 cases,respectively, and the incidence rates were 0.52%(21/4034) and 1.86%(75/4034), respectively . The number of abnormal electrocardiogram was 751 cases, and the incidence rate was 18.62%. The highest proportion of abnormal electrocardiogram was ST-T changes,accounting for 24.63%(185/751), followed by high-voltage, accounting for 18.11%(136/751), and left ventricular accounting for 13.85% (104/751). Sixty-one grain samples were collected and the wheat flour selenium level was averaged 0.034 mg/kg. Thirty hair samples were collected and the selenium median was 0.285 mg/kg. Conclusions The state of Keshan disease is in a steady state in Henna province, but higher rates of abnormal electrocardiogram is a serious problem and should be studied and prevented.

Objective To understand Kaschin-Beck disease(KBD) status in Henan Province and provide the basis for the further prevention and treatment of KBD. Methods Children aged 7 to 12 in 3 villages(Yaodian, Miaowa and Zhuyang) with the same environment such as topography, physiognomy,production mode and living habits in Shan County and Lingbao City were selected to undertake KBD clinical examination in 2008, X-ray examination of right hand and child hair samples and food samples were collected to determine the content of selenium. Selenium was determined using 2,3-Diaminonaphthalene method. Adults who were 16 years or older in 5 counties(Luoning, Lingbao, Mianchi, Shah and Lushi) were selected and examined for KBD. Results One hundred and ninty children aged 7 to 12 were clinically examined and clinical KBD were found, whereas 3 children were diagnosed as KBD by X-ray examination, the positive rate was 1.58% (3/190). All 20 521 adults were clinically examined and KBD prevelance rate was 6.10%(1251/20 521), including degree Ⅰ (3.97%,814/20 521), degree Ⅱ (1.77%, 364/20 521 ), degree Ⅲ (0.36%, 73/20 521). The average selenium contents in hair and food samples were (0.319±0.128)mg/kg and (0.031±0.009)mg/kg, respectively. Conclusions Child KBD in Henan Province is under control or almost under control, whereas the prevalence of adult KBD was relatively serious, which suggested that secondary prevention with the objective of clinically treating KBD patients should be strengthened.

The article discusses how to innovate in the departmental rotation examination for the students practicing in hospital in the new time.It is important for the teacher to provide guidance to students and motivate them to take part in comprehensive training of competence actively so as to cultivate the high-level medical students adaptive to the modern society.

Humanistic spirit advocates the concern for human,and the medical value of people foremost.Now status quo of oral medical students' humanities concern is worrying.This paper aims to analyze the reason,and the best way to culture oral medical students' humanities concern is not only to have an aim of training medical professionals who have oral medical knowledge and skills,but also to look upon the education of medical humanistic spirit as important educative content,to improve teachers' humanities diathesis,to enhance the contact between medical students' and society or patients,to foster affection,to train skills,and to establish the good environment of humanities education.

Objective To study the clinical characteristics of tracheotomy in patients with critical diseases and obesity aged 80 years and over. Methods A total of 120 patients with critical diseases and obesity undergoing tracheotomy from July 2006 to August 2011 were retrospectively reviewed,and divided into advanced age group(aged 80-99 years,n=60) and control group(aged 60-79 years,n=60).Surgery time,operation preparation,surgery skill and complication after surgery were compared between the two groups. Results A total of 60 patients undergoing tracheotomy were successfully performed by relative surgery skills according to characteristics of critical obesity in advanced age group.There was 1 case (1.7％) and 0 case with trachea cannula exodus,3 cases (5.0％) and 4 cases(6.7％) with cuff leak,4 cases (6.6％) and 3 cases(5.0％) with stoma bleeding,5 cases (8.3％) and 7 cases (11.4％) with subcutaneous emphysema in advanced age and control groups,respectively.Total complication rate was similar between the two groups of patients [13 cases (21.7％) vs.14 cases (23.3％),x2 =1.00,P＞0.05]. Conclusions Individualized procedure of tracheotomy may reduce complication of patients with critical diseases and obesity aged 80 years and over.

Breast Neoplasms ; chemistry ; pathology ; Carcinoma, Ductal, Breast ; chemistry ; pathology ; Electrophoresis, Polyacrylamide Gel ; methods ; Female ; Fluorescent Dyes ; Gelatin ; metabolism ; Humans ; Matrix Metalloproteinase 2 ; analysis

Objective To study the efficacy and safety of tacalcitol combined with monochromatic excimer light (MEL) 308 nm vs MEL 308 nm monotherapy in treating vitiligo.Methods Thirty-eight pa- tients with vitiligo were enrolled in the single-blind clinical trial,using plabebo-treated lesions in the same patient as controls.Contralateral or nearby lesions were randomly selected to be treated by either tacalcitol or placebo.All lesions were treated weekly with MEL 308 nm,for a total of 12 sessions.Patients were ex- amined at monthly intervals.The mean number of sessions and the cumulative dosage for initial and excel- lent repigrnentation were calculated.Results Thirty-five patients were evaluated.The mean?SEM cumu- lative dose and number of MEL exposures for initial repigmentation,respectively,were 4.27?3.59 J/cm~2 and 4.89?3.16 on tacalcitol-treated site,5.36?4.12 J/cm~2 and 5.69?3.29 on placebo-treated site,re- spectively (both P＜0.05).For excellent repigrnentation,the cumulative dose and number of exposures were 7.72?5.64 J/cm~2 and 7.79?4.70 respectively on tacalcitol-treated site,and 8.18?4.87 J/cm~2 and 8.4?3.92 respectively on placebo-treated site (both P＞0.05).Treatment with tacalcitol resulted in a sig- nificantly higher percentage (71.4% vs 54.3%) of repigmentation than that with placebo.Conclusions Our results show that MEL 308 nm is safe and effective for the treatment of vitiligo.Additionally,concur- rent topical tacalcitol potentiates the efficacy of MEL 308 nm in the treatment of vitiligo;this combination achieves more rapid pigmentation with a lower total MEL dosage.

Objective To investigate the effect of intraocular injection of mixed crystalline in vivo on survival of retinal ganglion cells(RGCs)after optic nerve cut.Methods Twenty Long-Evens rats were divided into normal control,and 7 day,14 day,and 21 day groups after optic nerve was cut off.There were 5 eyes in each group.Mixed crystallin(1x10~(-4)g/L)and isotonic saline solution were injected into the vitreous of fight eye and left eye respectively.The number of RGCs was counted 7,14 and 21 days after optic nerve cut.Results The density of RGCs declined clearly 7 days after optic nerve cut.In the group with crystallin injection,the density of RGCs declined to 71%,32% and 15% of the control group repec- tively,much higher than that of the controls on days 7,14 and 21 after optic nerve was cut off(P

Objective To investigate Feining granule on prevention and treatment of rat with radiation-induced lung injur ( RILI) and its effect on cytokine transforming growth factor-β1(TGF-β1), interleukin-1 (IL-1), interleukin-6 (IL-6).Methods 105 SD female rats were selected, according to random number table, and divided into seven groups: normal group, model group, dexamethasone group(positive drug), Feining granule low-dose group (FN low-dose group), FN medial-dose group, FN high-dose group and FN prevention group, 15 rats in each group.Except for normal group, all remaining groups received the X-ray irradiation of 15Gy, DT30Gy/2f/1w.FN prevention group were intragastric infused with FN granule one week before irradiation, and the other groups 48 h after irradiation.Five rats were sacrificed randomly at 2, 4, 6 weeks respectively, and right lung tissues were taken out.The contents of TGF-β1, IL-1 and IL-6 were detected by immunohistochemical method.ResuIts TGF-β1, IL-1 and IL-6 contents in lung tissue of model group at 2, 4, 6 weeks were higher than those of normal group (P<0.05).The above indicators after treated by Feining granule were lower than those of model group at each time (P<0.05),with a concentration-dependence manner to some extent.The above indicators in FN high-, medial-and low-dose group were higher than those in dexamethasone group (P<0.05), to some extent.However, the above indicators in FN prevention group were lower than those in dexamethasone group ( P<0.05 ) .ConcIusion Feining granule could prevent and cure radiation induced lung injury through decreasing TGF-β1, IL-1 and IL-6 content.The efficacy of dexamethasone is stronger than FN treatment groups, but is weaker than FN prevention.