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 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 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.

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.

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 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.

OBJECTIVE:To provide reference for further improving negotiation mechanism of drug medical insurance in Chi-na. METHODS:Questionnaire investigation was conducted among the medical insurance agency and pharmaceutical company staff who participated in drug medical insurance negotiation in Jiangsu province,Jiangxi province,Qingdao,Chengdu. Their business fa-miliarity and recognition of the negotiating mechanism were also investigated. The descriptive analysis,independent sample t test and other methods were adopted to analyze the data statistically. RESULTS:A total of 70 questionnaires were distributed and 68 val-id questionnaires were collected with effective recovery rate of 97.14%. Respondents included 21 staff members of medical insur-ance agencies and 47 of pharmaceutical companies. In terms of business familiarity,the average score of respondents in all aspects was greater than 3(4 points system),the lowest score wasmanagement of the implementation of drug negotiation projects. There were statistical significances in scores of 3 items between 2 parties in the negotiation(P<0.05):basic principles of the drug negotiation process should be followednegotiation objectives in the substantive negotiation process total score of busi-ness familiarity. The scores of respondents in pharmaceutical companies were higher than those of health insurance agencies. In the recognition of the negotiating mechanism,average score of each survey item was ≥4(5 points system)in the recognition of the overall effect of the negotiation mechanism except forwhich is conducive to maintaining the price system of pharmaceutical com-panies. The average score of all aspects of preparation of the negotiations,substantive negotiation,implementation of the negotia-tion agreement and negotiation project's supervision and evaluation was >4 except forpatients taking drugs is quick and easy. There was no statistical significance between 2 types of respondents in all aspects of overall effect of the negotiation mechanism, preparation of the negotiations and negotiation project's supervision and evaluation(P>0.05). But in the recognition of the substan-tive negotiation,there was statistically significance between 2 types of respondents innegotiations between the two sides in an equal,cooperative,harmonious atmosphere(P<0.05). Healthcare agencies'respondents had higher scores than pharmaceutical companies'ones. And in the recognition of the implementation of the negotiation agreement,there was statistical significance be-tween 2 types of respondents in theafter the agreement entered into force,the medical insurance agency will be strictly in accor-dance with the agreementandfund pay to pharmaceutical companies timely and reasonable(P≤0.05). Healthcare agencies're-spondents have higher scores for than pharmaceutical companies'ones. CONCLUSIONS:The current drug medical insurance nego-tiation mechanism shows good overall effect and runs smoothly. But there are still some shortages,such as collected information the preparation stage is not sufficient;the procedures of patients taking the drug is complicated;negotiating parties do not have equal status;the fund is not paid to the pharmaceutical enterprise timely;evaluation is not perfect.

Objective:To search for a better RT-PCR method for detecting CK19 mRNA. Methods: RT-PCR methods were used to detect the expression of CK19 mRNA in the tumor tissues and in the peripheral blood of patients with gastric cancer and in the peripheral blood of healthy subjects. Results: The influence of pseudogene and genome was observed through nonreversely transcripted RNA controls and comparison of several pairs of primers.The interference could be effectively eliminated by regulating the annealing temperature based on mismatched primers. Conclusion: The presence of pseudogene and genome interferes the experimental protocol in RT-PCR,which can be resolved with the method introduced in our paper.

Objective To investigate the compliance with endocrine therapy(ET) and assess the factors associated with treatment accuracy for breast cancer.Methods 379 patients with hormone receptor-positive breast cancer undergoing complete treatment from Jun.2006 to Jun.2008 in Jiangsu Cancer Hospital were followed up.Factors related to compliance were analyzed.Results Among the 322 (85.0％) patients successfully interviewed,15 (4.7％) patients did not receive ET,43 (13.4％) patients stopped taking drugs after discharge,14 (4.3％)patients had intermittent ET,and the rest 250 patients obeyed 5-year oral ET regularly.The treatment accuracy was 77.6％ (250/332).We found that majority of withdraw occurred within 2 months and within 2 years,accounting for 39.5％ and 48.8％,respectively.Job and education status were relevant to these patients.Moreover,too much concern of adverse drug effects and difficulty of long-term medication were the main reasons to noncompliance.Conclusions ET is effective in hormone receptor-positive breast cancer patients and has been used as a conventional therapy.However,due to the long therapeutic period and lack of medical supervision after discharge,its treatment accuracy and compliances are becoming low,resulting in decreased efficiency.It is therefore necessary to investigate such patients' management to improve the compliance and treatment accuracy of ET.

BACKGROUND:In rabbit femur fracture model experiment, there are a few studies on whether quadriceps tendon wil affect the stability of the fixed device. OBJECTIVE:To analyze the effects of quadriceps tendon to the stability of external fixator in rabbit models of femur fracture. METHODS:The 48 New Zealand white rabbits were randomly divided into two groups. External fixator was used to make fracture model. In the experiment group, quadriceps tendon was cut. In the control group, quadriceps tendon was retained. 2 weeks later, X-ray examination was utilized to observe the number of failed external fixator in both groups from modeling to success. RESULTS AND CONCLUSION:(1) X-ray examination:2 weeks after model establishment, external fixation frame screw was free from femur in one rabbit of the experiment group, and seven rabbits in the control group. Of them, one screw was broken. Threaded portion retained in the femur. (2) External fixation failure rate:failed external fixator was found in one rabbit in the experiment group, resulting in a failure rate of 4%, and 12 rabbits in the control group, resulting in a failure rate of 50%(P<0.05). These findings suggested that cutting off the rabbit quadriceps tendon can effectively ensure the stability of the external fixator, and indirectly improve success rate of the experiment.