Objective To investigate the correlation of p16 gene and p21 gene expression abnormal- ity with the prognosis of bladder carcinoma.Methods Using the search terms“bladder neoplasm”,“prognosis”,“p16”or“p21”,the literature on the correlation of p16 gene and p21 gene expression abnor- mality with the prognosis of bladder carcinoma were searched from MEDLINE database,PubMed database, CBMdisc and China Academic Periodical database,and were evaluated by Meta-analysis with Dersimonian- Laird model.Results A total of 19 trials involving 1584 patients(positive rate of 40.4%)were identi- fied,including 12 trials of 975 patients(positive rate of 37.4%)on p16 gene expression abnormality and 7 trials of 609 patients(positive rate of 45.4%)on p21 gene expression abnormality.The combined relative hazard(RH)of p16 gene expression abnormality on the prognosis of bladder carcinoma,p21 gene expression abnormality on the prognosis of bladder carcinoma and both p16 gene and p21 gene expression abnormality on the prognosis of bladder carcinoma was 3.70(95% CI,3.42-3.99),3.01(95% CI,2.81-3.21)and 3.18(95% CI,3.01-3.35),respectively.Conclusions Both p16 gene and p21 gene expression abnor- malities are biomarkers for poor prognosis of bladder carcinoma.The detection of these biomarkers may be helpful in making the treatment strategy.

Objective To introduce the experience and analyze the clinical outcome of applica- tion of reinforced bar-ring hybrid external fixator combined with limited internal fixation for complex frac- turcs of tibia plateau in patients.Methods From Aug.2002 to Feb.2005,21 patients with complex fractures of tibial plateau were treated with reinforced bar-ring hybrid external fixatar combined with lim- ited internal fixation.According to Schatzker classification,there were 13 patients with typeⅤfracture and 8 with typeⅥfracture.Voluntary and non-weight beating knee joint motion to partially weight bear- ing was taken one week after operation.Progressive loading was taken continuously until there was clinical evidence of fracture stability and then full weight bearing was done.Results The mean follow-up peri- od was 15.9 months (10-24 months).All the fractures got united and the mean union time was 4.2 months(3-8 months).All the injured knees could extend to less than 5 degrees and flex to more than 90 degrees after rehabilitation.Evaluated by Merchant score system for knee joint,81% of patients achieved excellent healing (7 cases) and good healing (10 cases).Conclusion Operation by using reinforced bar-ring hybrid external fixator combined with limited internal fixation can reduce complications and avoid stiffness of the knee joint.It is an effective method for complex fractures of tibial plateau.

Objective To evaluate surgical techniques and clinical results of percutaneous transforam-inal endoscopic discectomy in the treatment of far lateral lumbar disc herniation. Methods Thirty-sev-en patients (24 males and 13 females) with far-lateral lumbar disc herniation were treated by percutane-ous transforaminal endoscopic discectomy from September 2005 to October 2008. The mean age of the pa-tients was 40.6 years. There were 19 patients (51.4%) with foraminal lumbar disc herniation, 11 (29.7%) with extraforaminal lumbar disc herniation and 7 (18.9%) with mixed lumbar disc herniation. The mean operation time, stay-in-bed time, postoperative hospital stay were 70 minutes, 9 hours and 5.0 days respectively. The mean operation costed mean 9 800 ￥ RMB. Results All the patients were fol-lowed up for an average period of 11.5 months. The efficacy of percutaneous transforaminal endoscopic discectomy was determined by Visual Analog Score (VAS), Oswestry Disability Index (ODI) and Nakai criteria. The mean value of VAS was significantly decreased from preoperative 8.3±2.3 to 3.1±1.6 at postoperative month 3, and to 2.9±1.9 at postoperative month 6 (P < 0.01). The mean value of ODI was significantly decreased from preoperative 64.5±23 to 23.6±12.0 at postoperative month 3, and to 12.9±7.0 at postoperative month 6 (P < 0.01). According to the Nakai criteria, the outcome of the op-eration was excellent in 19 patients (51%), good in 13 (35%), fair in 2 (5%) and poor in 3 (8%), with overall excellence rate of 87%. Conclusions Transforaminal percutaneous endoscopic discecto-my is safe and efficacious in the treatment of far lateral lumbar disc herniations, and proper selection of patients is the key factor to ensure the outcome of the operation.

OBJECTIVE The objective of this study is to discuss when to dissect the lymph nodes behind the right recurrent laryngeal nerve (LN-prRLN) from the standpoint of the right cervical level Ⅵ-1 (superficial layer to the recurrent laryngeal nerve) lymph nodes in papillary thyroid carcinoma (PTC) patients.METHODS The clinical data of 306 bilateral or right PTC patients from the Hangzhou First People's Hospital who underwent dissection of level Ⅵ-1 lymph nodes and LN-prRLN between March 2014 and September 2015 were analyzed. We measured the number of level Ⅵ-1 metastatic lymph nodes and size of level Ⅵ-1 lymph nodes metastasis loci to predict the metastasis of LN-prRLN.RESULTS The number of level Ⅵ-1 metastatic lymph nodes and size of level Ⅵ-1 lymph nodes metastasis loci were risk factors of LN-prRLN metastasis(P<0.05). When the number of the level Ⅵ-1 metastatic lymph nodes was greater than 1.5, the AUC was 0.813 (the sensitivity was 78.43%, the specificity was 76.65%). The ROC showed that when the size of level Ⅵ-1 lymph nodes metastasis loci were more than 0.45 cm, the AUC was 0.726 (sensitivity was 90.20%, specificity was 48.90%).CONCLUSION In bilateral or right PTC patients with metastasis of level Ⅵ-1 lymph nodes, especially when the number of level Ⅵ-1 metastatic lymph nodes was greater than 2cm and the metastasis loci were more than 0.45 cm, we should dissect the LN-prRLN.

Animals ; Chromatography, Thin Layer ; Dichlorvos ; blood ; Dimethoate ; blood ; Insecticides ; blood ; Methyl Parathion ; blood ; Mice ; Organothiophosphorus Compounds ; blood

OBJECTIVETo identify the predictors of the positive results of transrectal ultrasound (TRUS)-guided biopsy for prostate cancer.

METHODSWe performed univariate and multivariate logistic regression analyses on the relevant data on 385 male patients that underwent TRUS-guided biopsy for prostate cancer, including such potential predictors as age, body mass index (BMI), symptoms, results of digital rectal examination (DRE), tPSA, fPSA, free/total PSA ratio (f/tPSA), prostate volume (PV), and PSA density (PSAD) for identification of the risk factors related to the positive rate of biopsy. Then we constructed a scoring system as a tool for predicting prostate cancer in repeat biopsies and determined the sensitivity of the system by calculating the false positive rate using the receiver operating characteristic curve.

RESULTSAmong the 385 patients, 139 (36.1%) were diagnosed with prostate cancer. On multivariate analysis, age (P < 0.01), DRE (P < 0.01), tPSA (P < 0.01), fPSA (P < 0.01), f/tPSA (P < 0.01), PV (P < 0.01), and PSAD (P < 0.01) were all significant predictors of prostate cancer. Multivariate logistic regression analysis showed age, tPSA, f/tPSA, PV, and PSAD to be independent predictors, with ORs and 95% CIs of 1.07 (1.05-1.16), 1.05 (1.02-1.15), 0.97 (0.86-0.99), 0.98 (0.87-0.96), and 1.79 (1.48-2.06), respectively. Moreover, patients with the risk score of 3-5 had a significantly higher rate of prostate cancer than those with 0-2 (64% vs 11%, P < 0.001).

CONCLUSIONThe scoring system on the key predictors of prostate cancer can help urologists to identify the men in need of prostatic biopsy.

Aged ; Digital Rectal Examination ; Humans ; Image-Guided Biopsy ; methods ; Logistic Models ; Male ; Middle Aged ; Prostate ; pathology ; Prostate-Specific Antigen ; analysis ; Prostatic Neoplasms ; chemistry ; pathology ; ROC Curve ; Risk Factors ; Ultrasonography, Interventional ; methods

OBJECTIVETo investigate the treatment of acute and chronic osteomyelitis with negative pressure wound therapy.

METHODThirty cases of acute and chronic osteomyelitis were treated with negative pressure wound therapy, assisted with debridement, autodermoplasty and myo-cutaneous flap surgery.

RESULTSNo evidence of relapse was found in all cases treated with negative pressure wound therapy. All the patients were followed up, range from 6 to 23 months, the average was 13.6 months.

CONCLUSIONThe negative pressure wound therapy maybe a simple, effective and inexpensive method, and could be one of the favorable therapy in the treatment of acute and chronic osteomyelitis.

Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Diseases, Infectious ; etiology ; surgery ; Chronic Disease ; Debridement ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Osteomyelitis ; surgery ; Surgical Wound Infection ; surgery

OBJECTIVETo evaluate the correlation of Ureaplasma urealyticum (Uu) and Chlamydia trachomatis (Ct) infections with male sterility.

METHODSData from CBMA and CNKI were searched and studies were made for the correlation of Uu and Ct infections with male sterility by retrieval strategy worked out according to the Collaborative Review Group search strategy. The results were expressed as odds ratio (OR) and 95% confidence intervals (95% CI). The results of 28 clinical controlled trials from 1994 to 2005 were analyzed by software RevMan 4.2. Odds ratio (OR) was applied to the evaluation of the correlation between Uu infection and male sterility.

RESULTSEighty-eight relative trials were retrieved, of which 28 were included in the Meta-analysis. The combined ORs of Uu and Ct infections to male sterility were OR(Uu): 4.73 (95% CI: 3.77-5.94) and OR(Ct): 4.59 (95% CI: 3.24-6.50).

CONCLUSIONUu and Ct infections are very important risk factors of sterility in Chinese men.

China ; epidemiology ; Chlamydia Infections ; complications ; epidemiology ; Chlamydia trachomatis ; Humans ; Infertility, Male ; epidemiology ; microbiology ; Male ; Meta-Analysis as Topic ; Odds Ratio ; Randomized Controlled Trials as Topic ; statistics & numerical data ; Ureaplasma Infections ; complications ; epidemiology ; Ureaplasma urealyticum

Arteriovenous Fistula ; diagnosis ; therapy ; Humans ; Male ; Middle Aged ; Recurrence ; Spinal Cord ; blood supply ; Thoracic Vertebrae

This article introduces a new radial arterial pressure signal pre-processing and heartbeat cycle recognition algorithm which can be used on left ventricular assist device. The algorithm is featured with the real-time processing, applicable to embedded platforms, delay compensation, avoiding arterial pressure baseline drift effects, recognizing heartbeat disorder.
Algorithms ; Heart-Assist Devices ; Humans ; Radial Artery ; physiology