Thevascularendothelialprogenitorcellsareapopulationoffunctionalendothelialprecur sorsincirculatingblood ,whicharederivedfrombonemarroworcordblood .CD34+,Flk - 1+andACl33+ aretheirmolecularmarkers .Inthisreview ,thefunctionalcharacterizationofvascularendothelialprogenitor cellsisintroducedandtherelationshipbetweenvascularendothelialprogenitorcellsandangiogenesisinis chemiccardiovasculardiseasesisdiscussed .Thesedatamayofferafoundationforthedevelopmentofthera peuticangiogenesisforthepreventionandtreatmentofischemiccardiovasculardiseasesbytransplantationof vascularendothelialprogenitorcells .

Controlling serum phosphorus levels is critical in patients with renal failure. Currently phosphate-binding agents are widely used to reduce phosphate absorption in patients with end-stage renal disease. If possible, serum phosphorus level should be reduced without disturbing calcium homeostasis or increasing accumulation of potentially toxic elements. Aluminum hydroxide and traditional calcium-based phosphate binders are commonly used to control serum phosphorus level. Aluminum hydroxide can effectively lower serum phosphorus level, but aluminum can accumulates in the body and results in toxic effect. Traditional calcium-based phosphate binders tend to promote hypercalcemia and calcium overloading, and accelerate cardiovascular calcification. Therefore aluminum-free and calcium-free phosphate-binding agents have become the focus of study; however, agents like sevelamer hydrochloride and lanthanum carbonate are not widely used due to high price, although they are effective in controlling serum phosphorus level. New generation of phosphate binders, such as colestilan, nicotinic acid and magnesium salt, are cheaper than their previous counterparts, but their long-term effect still needs to be observed. This article summarizes the progress of non-calcium phosphate binders in treatment of end-stage renal diseases, hoping to help clinical drug usage.

Objective To study the diagnosis and treatment of coincident vesical transitional cell carcinoma and prostatic cancer. Methods 8 cases of coincident vesical transitional cell carcinoma and prostatic cancer were evaluated clinically. Results All the 8 were diagnosed as vesical transitional cell carcinoma on cystoscopy and biopsy.Whereas on needle biopsy of the prostate,prostatic cancer was diagnosed in 7 and BPH in 1 but turned to be prostatic cancer on pathological study after cystoprostatectomy.4 patients underwent transurethral resection of the bladder cancer and bilateral orchiectomy with bladder instillation of MMC or BCG and oral flutamide for prostatic cancer.1 patient underwent partial cystectomy,bilateral orchiectomy and external radiotherapy for prostatic cancer.3 underwent radical cystoprostatectomy.2 cases were lost to follow up.In the other 6,3 survived less than 1 year because of wide metastasis.The other 3 have been followed up for 1.5 to 4.0 years,remained well and tumor free. Conclusions PSA detection together with rectal palpation,biopsy,transrectal ultrasonography and cystoscopy played the important role in the diagnosis of coincident vesical transitional cell carcinoma and prostatic cancer.Radical cytoprostatectomy yields a better outcome.

0 05) , repectively. Of all dementia, AD and VD accounted for 58 48% and 31 58%, respectively. The AD prevalence in female was higher than that in male( P 0 05). The prevalence of total dementia, AD and VD tended to increase with aging( P 0 05). The prevalence of dementia increased one fold every five year of age increasing. The prevalence of dementia and AD in illiterate group was higher than in educated people with elementary school level and above junior high school level ( P

Objective To evaluate intravesical instillation of mitoxantrone(MTZ) for the prevention of postoperative recurrence of bladder cancer. Methods Intravesical instillation of 12 mg MTZ dissolved in 50 ml normal saline and retained in bladder for 2 hours were given to bladder cancer patients postoperatively once a week for 8 weeks and subsequently once a month for 12 months.Kidney and liver function,blood counting,urinalysis and cystoscopy were taken periodically.The systemic and local reactions were recorded every time after the intravesical instillation. Results All of the 98 cases were followed up for 6 to 24 months with a mean of 13 months.The recurrence rate was 6.2%.There was no generalized side effect. Conclusions Intravesical instillation of MTZ was efficacious for the prevention of postoperative recurrence of superficial bladder cancer with safety and less side effect.So it can be widely used in such patients.

Objective: To study the influence of screening dementia with mini-mental state examination (MMSE) combining with delay memory test . Methods: MMSE and delay memory test are used in screening 301 residents. The diagnosis of dementia is according to the DSM-Ⅲ-R criterion. The validity and reliability were studied when the MMSE and delay memory test were used to screen dementia alone or combined. Results: When MMSE was used to screen dementia alone, the specificity, sensitivity, false positive proportion and false negative proportion were 85.40%, 52.43%, 47.56% and 14.60% respectively. When delay memory test was used to screen dementia alone, the specificity, sensitivity, false positive proportion and false negative proportion were 74.45%, 92.07%, 7.93% and 25.55% respectively. If parallel connection of MMSE and delay memory test were used to screen dementia, the specificity, sensitivity, false positive proportion and false negative proportion were 95.62%, 49.39%, 50.61% and 4.38% respectively. If MMSE was in series with delay memory test, the specificity, sensitivity, false positive proportion and false negative proportion of screening dementia were 64.23%, 95.73%, 4.27% and 35.77% respectively. Conclusion: The parallel connection of MMSE and delay memory test can elevate sensitivity of screening dementia and decrease false negative proportion, so it is important in epidemiologic investigation. MMSE in series with delay memory test will raise specificity of screening dementia and decrease false positive proportion, so it is useful for diagnosing early dementia.

Objective To analyze the reasons of early complications in anterior cervical spine surgery and its management. Methods Between Jan 1992 and Dec. 2003, 412 patients underwent anterior cervical surgery. There were 308 males and 104 females with an average age of 45.6 years (18-76). The di-agnosis of these patients included 258 of cervical spondylosis, 138 of cervical injury, 8 of cervical spinal tu-mor and 8 of tuberculosis of cervical spine. The medical history was from 4 hours to 20 years with an aver-age duration of 548 days. Among 412 patients, there were 58 cases (14.1%) with complete paraplegia, 192 cases (46.6%) with incomplete paraplegia and 162 cases without neurological deficits. Anesthesia used in this group of patients were local in 35, cervical plexus block in 52, local associated with cervical plexus block in 6, general in 318 and general associated with cervical plexus block in 1. Three surgical procedures were performed: 1) anterior decompression and interbody fusion with autogenous iliac crest in 33 cases; 2) anterior decompression and interbody fusion with threaded fusion cage in 32 cases; 3) anterior decompres-sion, interbody fusion with autogenous iliac crest and plate fixation in 347 cases. Results Fifty-one early complications occurred in 42 patients and the incidence was 12.37%. 28 patients (6.8%) had complications directly related to the procedure which included superior laryngeal nerve injury in 5, recurrent laryngeal nerve injury in 4, migration of bone graft in 2, infection or haematoma in 4, deterioration of neurological function in 5,nerve root injury in 2, loosening of screw or plate fixation in 2 and esophageal fistula in 1. 23 cases (5.08%) had early complications indirectly related to the procedure. Conclusion In order to reduce the incidence of early complications in anterior cervical spine surgery, make familiarization with anatomy, improvement of surgical skill as well as appropriate perioperative management are essential in anterior cer-vical spine surgery.

Objective To discuss the selection of surgical procedures for the treatment of spinal tu-berculosis according to the status of segmental stability of the spine. Methods One hundred adult patients with spinal tuberculosis were treated surgically between January 1998 and December 2003. There were 57 males and 43 females with an average age of 39.4 years and an average history of 16 months. The lesion ranged from T2 to S 2, and involved single vertebral body in 3 cases, double vertebral bodies in 66 cases, and more than two vertebral bodies in 31 cases. Of 100 cases, 32 were with neurological dysfunctions, and 65 were accompanied by kyphotic deformity with an average Cobb angels of 36.4? (20? to 48?). Preoperative chemotherapy of four drugs lasted more than two weeks. Three surgical procedures were performed according to the status of segmental stability of the spine: 12 cases without spine instability underwent single debride-ment, 8 cases of spine instability with debridement and interbody fusion, and 80 cases of significant insta-bility with debridement, fusion and internal fixation. Results All patients' incision healed without chronic infection and sinus formation. 95 patients were followed up with an average of 2.9 years ranged 1 to 77 years except 5 patients lost at follow up. 68 cases with anterior fusion achieved solid fusion in average 3.5 months. 65 cases with kyphotic deformity had an average correction of 20.2? postoperatively, and 2? to 4? loss during follow-up. 32 cases with neurological deficits had an improvement of neurological function postoperatively. One patient of L 4,5 tuberculosis treated with anterior debridement, fusion and instrumentation recurred at 7 months due to an inadequate postoperative chemotherapy of 6 months, and healed with a continuous chemotherapy for 18 months, However, satisfactory clinical results were obtained in other patients without any recurrence. A left external iliac vein was torn and repaired successfully in 1 case. Conclusion The maintenance of segmental stability has significant effect in the surgical treatment of spinal tuberculosis. Sta-tus of segmental stability of each patient should be evaluated preoperatively. Satisfactory clinical results can be achieved by proper selection of the surgical procedure according to the status of segmental stability.

DS ③Combined MMSE with one or more of FOM、RVR 、BD、DS,the validity of diagnosis was improved.Conclusion: Neuropsychological test is useful in diagnosis of AD.The validity is improved when MMSE are combined correctly with other rating scales.

[Objective]To study the role of nitric oxide on the degeneration of the cartilage endplate(CEP).[Method]Twenty-four New Zealand rabbits were divided into experiment and control groups.In the experiment group,the model of lumbar CEP degeneration was established by resection of all lumbar supraspinous and interspinous ligaments,excision of parts of zygapophysial joints and detachment of the posterior paravertebral muscles from lumbar vertebraes.Mechanical instability of the lumbar spine could induced the process of CEP degeneration.The X-ray examination of lumbar spine was examined by at 12,24 and 36 weeks with or without operation,respectively.Changes of the ultrastructure of CEP were also observed by scanning electron microscope(SEM) during this process,and the content of IL-1?,IL-6,TNF-? in the CEP were also detected during the periods.[Result]X-ray graph showed that the CEP calcified gradually with time increasing,and those of the experiment groups calcified more obviously than those of the control groups.The SEM showed that collagen fibers became thin,irregular and fissured and the content of proteoglycan decreased severely with the elapse of time.The changes in experiment groups were more obvious than those in control groups.The content of IL-1?,IL-6,TNF-? had a significant difference between the experiment groups and the control groups(P0.05).[Conclusion]It implies that inflammatary cytokin may play an important role in the development and progression of the degeneration of cartilage endplate.