Objective To evaluate the clinical significance of orthotopic continent detenial sigmoid neobladder.Methods 12 patients with bladder cancer were admitted and underwent radical cystectomy and detenial sigmoid neobladder.Results All the 12 patients were followed up for a mean of 18.6 months(range from 6 to 29 months).The blood Cr and BUN levels were both in the normal range without acidosis in all the cases.Only 1 had unilateral ureteral urine reflux during cystography.Of the 12 patients,11 cases(91.7%) achieved continence during daytime;2 cases(16.7%)were incontinent at night,but 1 case could control uri- nation by being woken up at night.The capacity of the neobladder was 220 to 550ml with a mean of 350ml and the maximal pressure of the neobladder during filling was 15 to 55cm H_2O(1cm H_2O=0.098kPa)with a mean of 35cm H_2O.Conclusion As a simple operation the detenial sigmoid neobladder can be performed easily with less complications and more reliable results.This operation may be generally applied in clinical practice.

[Objective]To evaluate long-term therapeutic effect of high tibial osteotomy HTO in the treatment of varus knee osteoarthritis.[Method]Eighteen males(twenty four knees)and eighty four females(ninety one knees)were accept HTO,patients were from thirty-five to sixty-five years,with average age 52.32(35～65)years.[Result]Ninety one knees were followed up from 10 years and 2 months to 21 years and 9 months,average 15 years and 1 month.HSS criterionwas used as evaluation standard,the ratio of excellent and good post operation 0.5 year,1 year,2,5,10,15 years were 98%,98%,98%,96%,78%,57%.[Conclusion]The therapeutic effect of HTO is good in the first 15 years,but it obviously degrade after 15 years,and HOA can work against time for prolongation of period before the possible later total knee replacement.

Objective To investigate the streptomycin(SM)-resistance of Mycobacterium tuberculosis (MTB) in urine and to examine their relationships with the mutation of rspL gene. Methods 47 strains of MTB were isolated from the urine of patients with renal tuberculosis.The mutation of rspL gene were analyzed by PCR-SSCP with silver-staining,and the strains were tested for the sensitivity to streptomycin. Results All the 47 strains had positive expression of rspL gene of MTB,with 28 SM-resistant and 19 SM-sensitive.Among the 28 SM-resistence strains 19(68%) had rspL gene mutation by SSCP testing.The 19 strains of SM-sensitive had no mutation. Conclusions Detecting mutation of MTB rspL gene in urine by PCR-SSCP can rapidly and exactly identify the MTB's sensitivity to streptomycin,which is significantly important in clinical treatment of anti-tuberculosis.

Objective:To evaluate the anti-tumor immune responses of nureplicable recombinant vaccinia virus-based vaccine expressing HPV16 L1 and L2E7 proteins.Methods:The anti-tumor effects of the vaccine were observed using mouse models of prophylactic,therapeutic and tumor excision.The cell-mediated immunity induced by the vaccine was assessed by enzyme-linked immunospot (ELISPOT) and cytotoxic T lymphocyte (CTL) assay.Results:The vaccine could protect 60% and 50% mice from the challenge of HPV16-positive tumor cells in prophylactic and therapeutic mouse model,respectively.It could protect from recurrence of the tumor in 70% mice of the excision model.The differences among the groups were significant.Strongly specific cell-mediated immunity was found using ELISPOT and CTL assay.Conclusion:The ideal anti-tumor immune responses can be induced by NTVJL1/L2E7 vaccine in mice and it can be considered to be one candidate vaccine of cervical cancer.

Natural killer cells (NK cells) are a class of cytotoxic lymphocytes and play an important role in anti-tumor immunity.There are many new advances from basic research to clinical applications in the 56th annual meeting of American Society of Hematology around the NK cells in Malignant hematological diseases.In this review,the progress will be given,which helps to understand the trend of NK cells in future clinical applications.

Objective To quickly pinpoint and correct errors in the application level in No.1 Military Medical Project. Methods LogMiner, a powerful tool provided by Oracle was used to mine and analyze the redo log files produced by oracle database in No.1 Military Medical Project. The basic concept, configuration and usage of LogMiner were described through an example of the Register Program in No.1 Military Medical Project. Results The errors made by Register Program was quickly pinpointed and then corrected by SQL statements provided by UNDO_VALUE field. Conclusion The method using LogMiner to pinpoint and correct the errors in the application level in No.1 Military Medical Project is simple, accurate and convenient. It should be a basic technique for maintenance personnel of hospital information system.

BACKGROUND: With the development of neural interventional therapy, the application of covered stents in neural intervention is becoming a topic of general interest.OBJECTIVE: To introduce the structure of stent-graft, and to summary the application of covered stents in clinical treatment of the neural interventional therapy and the shortage of covered stents.RETRIEVAL STRATEGY:The relevant articled were searched for in Pubmed database by researcher of this article with the key words of "stent graft, covered stents, cerebrovascular disease" in English, and with the key words of "covered stent, cerebrovascular disease" in Chinese in VIP database. 223 English and 196 Chinese articles were selected and reviewed primarily. Inclusive criteria: Articles having a close relation with the application of covered stents in neural intervention, especially in cerebrovascular disease, and the latest articles or articles published in authority journals in the same field were chosen. Exclusive criteria: articles with repetitive studies were excluded.LITERATURE EVALUATION: 223 English and 196 Chinese articles were primarily checked by reading titles and abstracts. Among the 31 collected articles, 4 are reviews, 3 are experimental studies and others are clinical studies.DATA SYNTHESIS: Covered stents show special advantages in neural interventional therapy and become a hot spot in present study. There are individual case reports or small group case reports on the application of covered stents in hemorrhagic cerebrovascular disease. It is reported that the covered stent effectively occludes aneurysm, dissecting aneurysm and arteriovenous fistula, keeps patency of the parent artery. The covered stent isolates ulcerated plaque via physical barriers, avoids the abscission of embolus, which can further reduce the development of embolism in percutaneous carotid artery stenting. After releasing covered stents, polytetrafluoroethylene makes the disepiment smooth. Its good biocompatibility reduces thrombosis, and then decreases the incidence of restenosis. Covered stents in vessel for cerebrovascular disease have achieved good effects, but there are some problems in clinic as follows. ①The main shortage of covered stents is to occlude small branch vessels. ②Thrombosis and restenosis occur after covered stenting. ③Covered stents increase the volume of the stent, reduce the compliance and flexibility of the stents, and increase the pushing difficulty and vascular injury. ④Covered stents cannot be used in vessels of less than 4 mm.CONCLUSION: Covered stents for intracranial ischemic and hemorrhagic diseases shows significant outcomes, but there are disadvantages. With the clarification of the related theories and the improvement of new material technology, there will be a brighter future of the application of covered stents for treatment of cerebrovascular diseases.

Objective To investigate the clinical effect of hyper-fractionated three-dimensional conformal radiotherapy (3DCRT) combined with transcatheter arterial chemeembolization (TACE) for heating patients with inoperable primary liver cancer.Methods One hundred and two patients with inoperable advanced primary liver cancer were divided by random digits table method into control group with 49 cases treated with TACE and observation group with 53 cases treated with hyper-fractionated 3DCRT combined with TACE.The short-term efficacy,adverse reaction and survival rate of the 1st,2nd and 3rd year and serum alpha-fetoprotein (AFP) expression after treatment in two groups were observed.Results The complete remission rate,progress rate and total efficiency were 17.0％ (9/53),11.3％ (6/53),73.6％ ( 39/53 ) in observation group,2.0％( 1/49 ),28.6％ (14/49),51.0％(25/49 ) in control group.There were significant differences between two groups (P ＜ 0.05).There was no statistical significance in adverse reactions between two groups ( P ＞ 0.05 ).The survival rates of the 1 st,2nd and 3rd year in control group were 51.0％ ( 25/49 ),28.6％(14/49),14.3％(7/49),the median survival time was 15 months;while those in observation groupwere 71.7％(38/53),52.8％(28/53),39.6％(21/53) and 20 months.The survival rates of the 2nd and 3rd year in observation group were significantly higher than those in control group respectively (P ＜0.05 or ＜0.01 ).The rate of patients with no obvious serum AFP protein change between observation group [ 9.8％(4/41) ] and control group [ 31.6％(12/38) ] had statistical significance (P ＜ 0.05).Conclusion Hyper-fractionated 3DCRT combined with TACE for treating patients with inoperable primary liver cancer has good clinical efficacy,it is worthy of clinical practice.

Objective To study the expression of KISS-1 in normal endometrium and in ectopic endometri-um patients with endometriosis. Methods The expression of KISS-1 in 55 cases of normal endometrium as well in 46 cases of ectopie endometriurn with endometriosis were detected by immunohistochemicai EliVision plus method. Results The positive expression rates of KISS-1 in ectopic endometriotic tissues and in normal endometri-urn were 30.43 % and 63.64 % respectively ,and the positive expression rates in ectopic endometriotic tissues signifi-cantly lower than those in the normal endometrium( P< 0.01, P < 0.05). Conclusion The decreased expression of KISS-1 may be related to the mechanism of endometriosis.

Objective To investigate clinical efficacy and safety of the memantine and donepezil in the treatment of moderate to severe Alzheimer's disease,in order to provide the basis for clinical treatment.Methods One hundred and twelve cases of moderate to severe Alzheimer's disease patients were given memantine plus donepezil(observation group) ,and single use of memantine treatment(control group), and the treatment for 24 weeks.Respectively before and after treatment, Mini Mental State Scale (MMSE), Alzheimer' s disease assessment scale (ADAS-cog), Alzheimer' s disease collaborative learning, daily life ability questionnaire (ADCS-ADL) ,and neuropsychological questionnaire (NPI) score, and adverse reactions were observed in the process of two kinds of therapy, the efficacy and safety of two kinds of treatment methods were evaluated.Results After treatment, the patients in observation group with MMSE, ADAS-cog, ADL and NPI evaluation results were (12.1 ± 2.1), (32.9 ± 8.3), (33.4 ± 5.0), (6.1 ± 3.1) scores, significantly improved compared with scoring (9.9±2.8), (46.2±7.6), (42.1±6.0), (10.5±2.9) scores before treatment,and the differences were statistically significant (t =2.138,-2.411,2.398, 2.107 respectively, P ＜ 0.05).The control group after treatment in patients with MMSE, ADAS-cog, ADL and NPI evaluation results were (12.3±2.6), (33.1 ±7.2), (35.1 ±6.6), (6.7 ± 2.9) scores, significantly improved compared with scoring 11.0 ± 2.5,44.9 ± 6.9,42.2 ±6.6,10.9 ± 3.5 before treatment, and the difference had statistical significanc (t =2.101,-2.033,2.105, 2.400 respectively, P＜0.05).After treatment, the difference of patients in the two groups of MMSE, NPI score had statistical significance(t =2.553,2.176, P＜0.05).The adverse reactions in two group respectively were 32.14％ (18/56) and 26.79％ (15/56), less difference was no statistical significance (P＞0.05).Vital signs checks,regular laboratory examination and ECG examination showed no obvious abnormalities.Conclusion Memantine combined with donepezil in the treatment of moderate and severe AD patients is superior to the singleeffect of memantine, and long-term use will not increase the risk of adverse reactions, which is safe and effective in the combined application.