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 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.

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 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.

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.

OBJECTIVETo compare the effect and impact of holmium laser enucleation of the prostate (HoLEP) and 120-W thulium: YAG vapoenucleation of the prostate (ThuVEP) on erectile function in the treatment of benign prostatic hyperplasia (BPH).

METHODSWe retrospectively analyzed 93 cases of symptomatic BPH treated by HoLEP or 120 W ThuVEP. We made comparisons between the two groups of patients in the baseline and postoperative clinical and surgical indexes as well as their IPSS, quality of life (QOL), maximum flow rate (Qmax), postvoid residual urine volume (PVR), and IIEF-EF scores before surgery and during the 12-month follow-up.

RESULTSThuVEP, in comparison with HoLEP, achieved a significantly shorter operation time ([57.6 +/- 12. 8] vs. [70.4 +/- 21.8] min, P = 0.001) and a higher laser efficiency ([0.71 +/- 0.18] vs. [0.62 +/- 0.19] g/min, P = 0. 021). At 1, 6, or 12 months of follow-up, no significant differences were observed in IPSS, OOL, Omax, and PVR between the two groups (P > 0.05). Both the HoLEP and ThuVEP groups showed low incidences of complications and remarkably improved IIEF-EF scores at 12 months postoperatively, but with no significant differences (both P > 0.05). However, in those with relatively normal erectile functions before operation, the mean IIEF-EF score was reduced from 22.8 +/- 2.2 preoperatively to 21.0 +/- 2.7 after HoLEP, (P = 0.036).

CONCLUSIONBoth HoLEP and 120W ThuVEP are effective and safe in the treatment of BPH. Compared with HoLEP, 120 W ThuVEP has even a higher laser efficiency. However, neither can significantly improve erectile function, and HoLEP may have a short-term negative impact on the relatively normal erectile function of the patient.

Aged ; Holmium ; Humans ; Laser Therapy ; adverse effects ; methods ; Lasers, Solid-State ; therapeutic use ; Male ; Middle Aged ; Penile Erection ; Prostatectomy ; adverse effects ; methods ; Prostatic Hyperplasia ; surgery ; Quality of Life ; Retrospective Studies ; Thulium ; Transurethral Resection of Prostate ; Treatment Outcome ; Urine

Female ; Human papillomavirus 18 ; physiology ; Humans ; Papillomavirus Infections ; complications ; Risk Factors ; Uterine Cervical Neoplasms ; epidemiology ; etiology ; pathology ; virology ; Virus Integration ; genetics ; physiology

Objective To investigate the relationship between coagulation function and the tumor size, clinical stage and metastasis status in renal cell carcinoma (RCC) patients. Methods A total of 290 RCC patients from 2004 to 2009 were included in present study. There were 181 male patients and 109 female patients. The average ages was (56.3± 13. 5) years. There were 252 cases of clear cell carcinoma, 19 cases of papillary carcinoma, 5 cases of chromophobe cell carcinoma, 3 cases of cystic RCC, and 11 cases of other types. TNM classification: stage Ⅰ 202 patients, stage Ⅱ32 patients , stage Ⅲ 32 cases, stage Ⅳ 24 cases. There were N0 264 patients, N1 11 patients and N2 15 cases. There were M0 273 cases, M1 17 cases. One hundred and eighty-six cases of benign renal tumors were set as the control group. Fibrinogen (Fib), prothrombin time (PT), activated partial thromboplastin time (APTT) and international normalized ratio (INR) were detected. Results The preoperative serum Fib of RCC patients was (39. 6±15.6) g/L, the control group was (32. 8±8. 2)g/L. There was significant difference between them (P<0. 05). The values of preoperative APTT,INR, and PT were (31.7±5.2)s, (1.0±0. 1), (11.2±1.3)s in RCC group and (32. 4±4.2)s,(1.0±0. 1), (11.1±1.3)s in the control group. There were no significant differences between them (P＜0.05). The values of Fib in stage Ⅰa, Ⅰb, Ⅱ, Ⅲ, Ⅳ groups were (32. 6±6. 6), (36. 1±8. 7),(48.8±21.6), (49.9± 17.8) and (59.7± 19.2)g/L, respectively. There was no significant difference between stage Ⅰ, and the control group. But the other stages showed significant difference with the control group (P<0.01). Hyperfibrinogenemia (Fib>44.0 g/L) in the RCC group accounted for 74 cases (25.5%). If the value of Fib ≤44. 0 g/L, 92.1% of patients can be excluded from the probability of metastasis. Conclusions Preoperative plasma Fib levels could be elevated in RCC patients with distant metastasis or lymph node metastasis. Increased preoperative plasma Fib levels, especially hyperfibrinogenemia may be a predictor of metastasis.