Objective To evaluate urodynamic diagnosis of intrinsic sphincter deficiency (ISD) in female stress urinary incontinence. Methods Leak-point pressures (LPP) and maximum urethra close pressures (MUCP) were detected in 30 patients with female stress urinary incontinence,among whom there were 11 cases with type Ⅲ,19 type Ⅱ/Ⅲ. Results Of type Ⅲ incontinence the LPP was less than 50 cmH 2O in 10 out of 11 and in 17 out of 19 type Ⅱ/Ⅲ incontinence the LPP 50～100 cmH 2O ( P

Objective To assess the relationship between polymorphism of XRCC1 Arg194Trp Arg399Gln and ESCC TNM stage and regional lymph node metastasis. Methods PCR and PCR-RFLP were used to detect polymorphism of XRCC1 Arg194Trp and Arg399Gin. The results were analyzed and compared to TNM staging and regional lymph node metastasis. Results The XRCC1 194Arg/Trp and 399Arg/Arg wildtype in ESCC with metastasis is 32.3%, which is higher than 194Arg/Arg (20.0%, P=0.01). There was no remarkable difference between IIb-IV stage ESCC with lymph node metastasis and 0-IIa stage without metastasis. Conclusion The ESCC patients with 194 variability and 399 wildtype had high metastasis rate, XRCC1 Arg194Trp and Arg399Gln had relationship with ESCC TNM stage and lymph node metastasis. Both of them affected to prognosis of ESCC.

[Objective]To investigate the characteristics of the distally based sural neurofasciocutaneous flap for repairing soft tissue defects in heel.[Method]From June 2002 to July 2008,58 cases of soft tissae defects in heal were repaired with distally based sural neurofasciocutaneous flaps.Among them,10 cases combined with a dead cavity,13 cases were innervated with the anastomosis of the sural nerve to the cutaneous nerve of recipient site.The size of the flaps ranged from 8 cm?4 cm to 20 cm?15 cm.The perforating barnches of peroneal artery in fascia pedicle were exposed first,and then the flaps were harvested.[Result]Forty-six flaps survived uneventfully.Necrosis took place in the distal part in 12 flaps,and the wounds healed after changing dressing daily,two-stage suture or skingrafting.Through 1 to 34 months of follow-up,all the survival flaps provided good contours.Infection was controlled and no recurrence,ulcer or pressure sore was found.Walk function was good.[Conclusion]Distally based sural neurofasciocutaneous flaps for reparing soft tissue defects have many advantages.It can offer abundant blood supply,large survival size,simple operation,high achievement rate,and re-establishment of protective sensation.The flaps can repair almost all defects in heel.

Objective:To explore the diagnosis and treatment of small intestine leiomyosarcoma. Methods:Ten patients with small intestine leiomyosarcoma in Changhai Hospital from 1993 to 2001 were retrospectively analyzed. Results:Radical resection was performed in 6 cases with the shortest survival time being over 1 year and the longest being 8.5 years (still in good health). One case received extirpation operation with the survival time being over 4 years.Partial resection was performed in 3 cases,and the 3 patients died 1,2,3 years after operation respectively.Conclusion:The small intestine leiomyosarcoma is rare and its diagnosis is difficult due to the lack of clinical feature. Final diagnosis should be based on pathology.The disease is not very sensitive to radiotherapy and chemotherapy,which makes surgical treatment the choice.

BACKGROUND:Apoptosis,which result in various reasons,plays an important role in intervertebral disc degeneration. One of important reasons for apoptosis is oxidative stress. OBJECTIVE:To investigate effects and mechanism of hydrogen-peroxide(H2O2) on nucleus pulposus cell injury induced by oxidative stress at intracellular signal transduction level in rats. DESIGN,TIME AND SETTING:A single sample observation was performed at the institute of Traumatology and Orthopaedics of Shandong Province from March to October in 2008. MATERIALS:The specific p38 mitogen-activated protein kinase(p38 MAPK) inhibitor SB203580,the specific JNK inhibitor SP600125 were purchased from Beyotime Institute of Biotechnology;Two 24-hour-old SD rats of SPF degree were purchased from Qingdao Institute for Drug Control. METHODS:The primary cultured nucleus pulposus cells were divided into four groups:the H2O2 group,stimulated by H2O2 with concentrations of 0,50,100,200,400,and 800 ?mol/L;Control group;SB203580+H2O2 group:cells were preincubated with SB203580,and then were treated by stimulated by H2O2;SP600125+H2O2 group,cells were preincubated with SP600125,followed by stimulated by H2O2. MAIN OUTCOME MEASURES:The expression and cellular localization of P-p38MAPK and P-JNK was detected by immunohistochemistry,and the expression of total and phosphorylated SAPK/JNK,p38MAPK were measured by Western blotting. RESULTS:H2O2 could activate the activity of P38 and JNK. The expression of P38MAPK was significantly inhibited with the pretreatment of SB203580;however,the SP600125 could inhibit the expression of JNK. Immunofluorescence analysis demonstrated that P-p38MAPK and P-JNK were expressed and distributed mainly in cytoplasmic and nuclear exception of the control group. CONCLUSIONS:Apoptosis of rat nucleus pulposus cells are induced by oxidative stress via p38MAPK and JNK signal pathway.

Background and purpose:Osteosarcoma is the most common primary malignant bone tumor in the children and young adults. Until now, there is no prognostic indicator with high speciifcity and high sensitivity. This study investigated the relationship between miR-92a level in palsma and clinical pathological characteristics, as well as the prognosis in osteosarcoma.Methods:The plasma from 30 healthy volunteers who underwent physical examination and from 45 cases of osteosarcoma before and after operation were collected. The miR-92a level was detected by real-time lfuorescent quantitative polymerase chain reaction (RTFQ-PCR) method. According to the relative expression≥5 of miR-92a, the osteosarcoma patients were divided into 2 groups: miR-92a high expression group and low expression group.Results:The miR-92a level in palsma from osteosarcoma is signiifcantly higer than that from healthy volunteers. Before surgery, the miR-92a level was markedly higher than after surgery. There was no correlation between the miR-92a level and the gender, age, tumor location, tumor size and histological type. However, signiifcant correlation was found with Enneking grade, tumor cell necrosis rate and lung metastasis. Compared with the low-expression group, high miR-92a expression was associated with a signiifcantly shorter overall survival using Kaplan-Meier analysis (P=0.035). Conclusion:The results suggest a signiifcant relationship between miR-92a and survival ratio. miR-92a expression level may be a useful prognostic indicator in osteosarcoma.

ObjectiveTo retrospectively analyze the experience in the treatment of cardiac rupture caused by blunt chest trauma and to explore the approaches and methods to improve patient survival.Methods From 2004 to 2010,16 cases of closed chest trauma caused by cardiac rupture,who were treated in our hospital,were treated by heart repair using median sternotomy incision approach.Results Except for 1 patient occurred cardiac arrest before the establishment of CPB,who was failed for cardiopulmonary resuscitation after surgical repair,the remaining 15 patients were all successfully treated.Conclusion The diagnosis of cardiac rupture should be made as soon as possible once it occurs.Timely and decisive rescue and emergency surgery should be given.Heart repair can greatly improve the patient's survival.

Objective To explore the difference of the level of Th1/Th2 balance and change of CD4+ CD45R cell after treated by laparoseopy-assisted rectal cancer surgery and conventional open rectal cancer surgery, so to compare the effect of the two procedures on immunity function of the patients. Methods CD4+ IFN-γ+ T cell (Thl cell), CD4+ IL-4 + T cell( Th2 cell)and the ratio of Th1/Th2 were detected by flow cytometery ; The levels of IFN-γand IL-4 were measured by ELISA. The changes of CD4 + CD45RA+ T cell and CD4+ CD45RO+ T cell were detected in the different procedures so that the effect of the two procedures on eytoimmunity and immune balance were analyzed. Results Compared with baseline levels, the level of Th1 cells was decreased [ (4.51±1.52 ) %, (7.26 ±2.59) % vs. ( 12.06 ±1.82 ) % ] (P < 0.05 ) ; The level of Th2 cells was increased [ (6.70 ± 2.41 ) %, (6.70 ± 2.41 ) % vs. (4.47 ± 1.90) % ] ( P < 0.05 ) ; The level of IFN-γ was decreased [ (57.15± 23.64) ng/L, (72.70 ± 27. 31 ) ng/L vs. ( 123.47 ± 32. 52) ng/L ] ( P < 0. 01 ) ; The level of IL-4 was increased [(55.55±7.29)ng/L,(57.56 ±7.13)ng/L vs. [(41.87±5.83)ng/L] (P<0.05) on 2nd and 7th day after conventional open reeatal cancer surgery; The level of Thl, Th2, IFN-γ and IL-4 in the laparoscopy-assisted rectal cancer surgery was not different ( P > 0.05 ). At 7 day postoperatively, the level of the CD4+ CD45 RA+ T cells was in-creased (35.11 ±7.82) and the CD4+ CD45RO+T cells was decreased(61.21±9.13) compared with surgery be-fore(31.11±6.72) and (68.11 ±11.42) respectively (P< 0.05). Conclusions The laparoscopy-assisted rec-tal cancer surgery has less influence on immune balance, thus protect systemic cell immunity.

Objective To observe whether bone marrow mesenchymal stem cells (MSCs) can promote the repair of IgA nephropathy and to explore its possible mechanism. Methods Sprague-Dawley rats were randomly divided into three groups which were MSCs injection group, normal saline(NS) infusion group and healthy control group. IgA nephropathy model was established by the improving method with BSA +SEB +CCl4 in former two groups. MSCs of SD rats were continuously cultured in vitro and identified with specific surface antigens by flow cytometry and osteogenic and adipogenic differentiation. MSCs were labeled with bromodeoxyuridine (BrdU) in vitro before transplanted. At 1st and 4th week after MSCs injection, the changes of body weight, urine protein, renal function, histopathology and IgA immunofluorescence were observed. MCP-1, TGF-β1 in urine were detected by ELISA. The expression of MCP-1, TGF-β1 in kidney were examined by RT-PCR. The cytokines and BrdU labeled MSCs were detected by immunohistochemistry to observe the disposition in kidney. Results At the end of the first week of MSCs transplantation, MSCs group urine protein (36.86±4.78) mg/24 h, serum creatinine (53.50±6.28) μmol/L, and the NS group urine protein (66.98±5.86) mg/24 h, serum creatinine (82.50±8.36) μmol/L, the differences between two groups were significant (P<0.05). At the same time, the content of MCP-1, TGF-β1 in urine and expression in renal tissue of MSCs group were obviously less than those of NS group (P <0.05). At the end of the 4th week, the body weight, histopatholngy, IgA immunofluorescence of MSCs group were remarkably improved as compared with those of NS group. The content of MCP-1, TGF-β1 in urine and expression in renal tissue, and renal pathological change in MSCs group had no significant differences as compared with those of healthy control group. As the time passed, the disposition of BrdU-labeled MSCs in kidney was taper. Conclusions MSCs injection contributes to renal repair in rat IgA nephropathy. The mechanism may partly depend on adjusting the excretion of cytokines in renal microenvironment and/or other functions rather than completely depend on their differentiation to renal cells.

Objective To explore the clinical significance of serum ProGRP in diagnosis of SCLC.Methods Serum ProGRP were detected in twenty-three SCLC patients,forty NSCLC patients and forty-three patients with benign pulmonary disease whose were definite diagnosis collected from April 15,2016 to July 19,2016,and a contemporary cohort of 40 healthy controls were while recruited.Results The levels of ProGRP in SCLC group were significantly higher than those in NSCLC group,benign pulmonary disease group and healthy control group(P <0.05).The levels of ProGRP in extensive disease group were significantly higher than those in 1imited disease group(P <0.05).There was no significant difference in the positive rates of ProGRP between the sex group and age group (P > 0.05 ).The boundary value of diagnosis of SCLC through ProGRP identified through ROC curve was 65.66 ng/L.The sensitivity and specificity of the ProGRP for the diagnosis of SCLC were respectively 90.9% and 89.9%.Conclu-sion Serum ProGRP can be use as a sensitive and specific index for diagnosis of SCLC,and the level of ProGRP can also be used for the clinical staging of SCLC.