Objective To investigate the clinical effect of transurethral resection of bladder tumor (TURBt) combined with internal iliac artery embolization in treatment of elderly invasive bladder cancer patients with high risk.Method From February 2010 to May 2016, 26 cases by ultrasonography, CT and cystoscopy were diagnosed with muscle invasive bladder cancer but high-risk patients cannot tolerate radical cystectomy with transurethral resection of bladder tumor (TURBt) combined with internal iliac artery infusion chemotherapy and embolization treatment, TURBt could be used in chemotherapy before or after chemotherapy, specific depending on the size of the tumor and the patient may be.Result The operation and internal iliac artery embolization chemotherapy in 26 patients were successfully completed. Preoperative embolization in 16 cases, 18 cases of postoperative chemoembolization 1 times, 2 times in 9 cases, 3 times in 5 cases,. Among them, 7 cases relapsed again, TURBt, 2 cases of recurrence, third cases of TURBt, 3 cases of recurrence of preoperative embolization chemotherapy 1 times. Transurethral resection of the prostate (TURP) in 6 patients with benign prostatic hyperplasia (BPH) and transurethral resection of the prostate. No serious complications associated with surgery, no perioperative death. Postoperative pathological report was a muscle invasive transitional cell carcinoma. No bone marrow suppression, anemia, liver and renal function damage and other serious side effects were not occurred during the chemotherapy. After the operation, the patients were followed up from 3 months to 6 years, 2 cases died within 2 years, 4 cases died within 2 to 5 years, 18 cases were alive, 2 cases were lost to follow-up.Conclusion For patients at high risk for muscle invasive bladder cancer, TURBt combined with internal iliac artery embolization chemotherapy, minimally invasive, less pain, less complications, to avoid the high risk of radical cystectomy and caused by urinary diversion due to the decline in the quality of life, can delay the disease progression. Safety and efficacy.

Objective To explore the effects of microwave radiation from interphone on the electrocardiogram of occupational population. Methods 165 male security personnels (working age: 0.5-3.32 a) often exposed to microwave radiation from interphone and 80 male staffs (working age: 0.5-3.58 a) without exposure to microwave radiation in a same security guard company were selected for examination of electrocardiogram in June-July,2004. Results The prevalences of sinus arrhythmia,sinus bradycardia,and the total abnormal rate of electrocardiogram in exposure group were significantly higher than those in control group(P

33 cases were treated by spotted—moxibustionwith Zhuang medicated threads,the effective rate be-ing 84.6～85.0%.The longterm effect was also satis-factory.This therapy can also markedly raised the in-filtration pressure of nocturnal urination.There wasno obvious relation between the therapeutic effect andsyndrome typing.

Objective To explore osculating value method combined with rank sum ratio method in evaluation of nursing quality in the hospital nursing management application, to provide a scientific basis for decision making. Methods By reference, from the working efficiency, the quality of nursing, 3 dimensions of nursing skill training, the choice of 11 commonly used in the evaluation of nursing quality indicators, the raw data of each index was normalized, the school of nursing quality with 2004-2013 years of osculating value method analysis was assessed, the development of nursing quality combined with rank and file classified score method. Results The nursing quality of the overall upward trend, according to the grading each year osculating value and ranking in 2011, nursing quality best, osculating value was 0.000, the worst quality of nursing in 2004, osculating value was 3.248;the annual nursing quality grading was reasonable, 2011, 2012 and 2013 were in good quality grade, 2004, 2005 and 2006 were of poor quality grades, the rest of the year at a medium level, with statistically significant difference of the file, P<0.05. Conclusion Osculating value method combined with rank sum ratio method in comprehensive evaluation of nursing quality in the hospital has the objectivity and practicability.

Objective:To discuss the surgical techniques and evaluate the clinical effects of laparoscopic varicocelectomy with testicular artery preservation.Methods:In this retrospective study, we collected clinical data of 97 patients with varicocele who underwent laparoscopic varicocelectomy from January 2015 to June 2020. All operations were performed by the same experienced urologist. Conventional laparoscopic varicocelectomy without testicular artery preservation was performed in earlier 35 patients (January 2015 to December 2016), which were taken as control group. The latter 62 patients (January 2017 to June 2020) underwent laparoscopic varicocelectomy with testicular artery preservation were taken as observational group. In observational group, average age was (21.9±6.7)years, there were 47 cases on the left side, 3 cases on the right side and 12 cases bilaterally, totaling 74 sides. There were 22 sides of varicose veinsⅠ, 28 sides of varicose veinsⅡand 24 sides of varicose veins Ⅲ. Clinical manifestations such as scrotal discomfort, pain and scrotal vein masses were observed on 35 sides (47.3%), infertility was observed in 24 cases (38.7%). Average sperm density was (23.7±5.9)×10 6/ml, average sperm motility (grade a+ b) was (33.9±4.1)%. In control group, average age was (23.7±4.6) years, there were 26 cases on the left side, 2 cases on the right side, 7 cases bilaterally, totaling 42 sides. There were 10 sides of varicose veinsⅠ, 17 sides of varicose veinsⅡ, 15 sides of varicose veinsⅢ. Clinical manifestations of scrotal discomfort, pain and scrotal vein masses were observed on 19 sides (45.2%), infertility was observed in 14 cases (40.0%). Average sperm density was (22.3±6.2)×10 6/ml, average sperm motility (grade a+ b) was (32.6±4.8)%.There was no significant statistical difference in preoperative clinical data between two groups ( P>0.05). The observational group followed the procedural steps of freeing the spermatic cord, isolating the testicular artery, and ligating the spermatic vein. The testicular artery was separated by the separating forceps and the electric hook, with the separating forceps holding the spermatic cord fascia in place and the electric hook (without electricity) bluntly separating the blood vessels and lymphatic vessels in the spermatic cord. The operative time, complications, recurrence rate, improvement rate of scrotal symptoms and semen quality, spontaneous pregnancy rate of spouses within 2 years in infertile patients were compared between the two groups. Results:The mean operative time in observational group was longer than control group [(35.8±7.7)min vs.(16.5±5.5)min, P<0.001]. Occurrence of postoperative acute epididymitis was lower in observational group compared to control group [1.4% (1 side) vs. 11.9% (5 sides), P<0.05] . No testicular atrophy (0 side) occurred in observational group, however, this complication could be found in 7.1% (3 sides) of control group ( P<0.05). Improvement rate of scrotal symptoms and semen quality was higher in observational group than that in control group after operations [77.1% (27 sides) vs. 47.4% (9 sides), P<0.05; and 72.6% (45 cases) vs.51.4% (18 cases), P<0.05]. The rates of spousal natural pregnancy within 2 years in infertile patients was higher in observational group than that in control group [70.8% (17 cases) vs. 50.0% (7 cases), P<0.05]. The rates of hydrocele and scrotal edema were similar in two groups [9.5% (7 sides) vs. 9.5 (4 sides)%, P>0.05], and the recurrence rate of varicocele was similar [8.1% (6 sides) vs. 7.1% (3 sides), P>0.05), without statistically significant difference. Conclusions:Using separating forcep and electronic hook can help to separate the testicular artery when performing laparoscopic varicocelectomy. In this operation, to preserve the testicular artery can get better effects an less complications.

Objective To investigate the effect of cetuximab (C225) combined with radiation on the expressions of Ku80 and ATM in CNE-2 nude mice xenograft tumor model.Methods The CNE2 nude mice xenograft tumor model was established and divided into control group,conventional radiotherapy (CRT) group,simulated intensity modulated radiation therapy (sIMRT) group,C225 group,CRT + C225 group and sIMRT + C225 group with 8 mice in each group.The dose of radiation was 20 Gy,and 1mg C225 per mice in abdominal cavity was applied for the drug treatment.The transcriptional levels of Ku80 and ATM were assayed by RT-PCR and Western blot.Results Compared with control group,the transcriptional and translational levels of Ku80 and ATM in CRT group,sIMRT group,CRT + C225 group and slMRT + C225 group were decreased (P ＜ 0.05).Compared with CRT group,the down-regulation of transcriptional and translational ATM level in sIMRT group was obvious (P ＜ 0.05),and further strengthened in the CRT + C225 group and sIMRT + C225 groups (P ＜0.05),but there was no significant difference of ATM expression between sIMRT + C225 group and CRT group (P ＞ 0.05).Conclusions C225 alone can restrain the transcriptional and translational level of ATM,and the transcriptional and translational level of Ku80 and ATM are also restrained after megadose.ATM is down-regulated by sIMRT but up-regulated by the combination of C225 and radiation.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) have a remarkable differentiation potential and superiority as a type of seed cells,but their application is limited in the presence of certain diseases,such as aplastic anemia and myelogenous neoplasm.The present studies have found that seed cells called muscle-derived stem cells (MDSCs) have brought more and more attention,because of their capability of stir-renewal and multi-diffcrentiation like B MSCs.OBJECTIVE: To explore the biological characterization of the muscle-derived stem cells (MDSCs) from rabbits,and analyze the phenotype.DESIGN,TIME AND SETTING: Cell in vitro observation experiment was performed at the Medical Research Center of Second Affiliated Hospital of Sun Yat-sen University from August 2005 to March 2006.MATERIALS: A New Zealand rabbit (1.5 months old,clean grade) was enrolled for the preparation of Muscle-derived stem cells.Growth medium was DMED-LG added with 10% fetal bovine serum and 10% horse serum and fusion medium was DMEM-LG added with 2% fetal bovine serum.METHODS: The muscle mass was removed from the anesthetized rabbit to isolate MDSCs.These cells were dissociated using three enzymes (collagenase XI,dispase and trypsin) respectively.Sediment was resuspended.Then preplate technique was used.The muscle cell extract was plated on a collagen-coated culture flask with growth medium.The flask was called PP1.PPI was kept overnight in a 37 ℃ incubator containing 5% CO2,After that,the suspension was transferred to another collagen-coated culture flask,which was called PP2.PP3,PP4,PP5 and PP6 were constructed later following the same procedures.The cells adhered in PP6 were collected,plated in 6-well plates,and divided into 2 groups.Growth medium was used in one group,in which the cells were kept growing at a degree of confluence beyond 50%,and fusion medium was used in the other one,in which the cells were passaged with a degree up to 30%.MAIN OUTCOME MEASURES: The cells from PP1 to PP6 were collected,and the characterization was identified preliminary by Flow cytomctry,Immunocytochemistry and Western Blotting.The fusion of cells in PP6 was detected at different confluence degrees and concentration of medium.RESULTS: The cells in PP6 showed ＞ 80% desmin+,＞ 70% Bcl-2+,＞ 95% CD45,which indicated that MDSCs were in a high concentration.The expressions of α-SMA in the cells were decreasing with the Preplate technique used and the cells in PP6 almost had no α -SMA expression.When passaged at a high confluence (＞ 50%) or cultured with low concentrations of serum (2% serum),the cells in PP6 had a strong tendency of fusing into myotubes or cell chains and were skeletal myosin+.CONCLUSION: MDSCs,which are capable of multi-differentiation under a high fusion or low serum conditions,express dcsmin and Bcl-2 highly,but extreruelv little CD45 and no α -SMA.

Objective To investigate the role of bone marrow mesenchymal stem cells (MSCs) transplantation in repairing injured intestinal mucosa of acute pancreatitis.Methods MSCs were harvested and cultured from femurs of male SD rats.Twenty female SD rats were divided into three groups,and serve acute pancratitis (SAP) model was induced by intraperitoneal injection of L-arginine (2 g/kg) twice.Twelve hours after SAP model established,MSC transplantation group (n=8) were injected MSCs (5 × 106 cell/rat) through tail vein for three days,and SAP group (n=6) were injected the same volume of saline through tail vein as control.Control group (n=6) were only injected the same volume of saline without any treatment.All the rats were sacrificed at 72 hours after model established.The small intestinal tissues were taken for HE staining and pathological score,the TNF-α mRNA and IL-1β mRNA expression level in small intestine and pancreas were tested by RT-PCR.Y chromo-some (Sry) gene in pancreatic and intestinal tissue was examined by polymerase chain reaction (PCR).Results The relative expression quantity of TNF-a mRNA and IL-1β mRNA in pancreas was significant higher in SAP group and MSC transplantation group than in control group (7.22 ± 1.99,3.46± 1.75 vs 1.32 ± 1.04 ; 2.71 ± 0.56,1.92 ± 0.28 vs 0.61 ± 0.45 ),the difference was statistically significant (F=18.375,F=22.701; P＜0.05).Compared with SAP group,the expression quantity of TNF-α mRNA and IL-1β mRNA in pancreas was significantly decreased in MSC transplantation group,the difference was statistically significant (P＜0.05).The relative expression quantity of TNF-α mRNA and IL-1β mRNA in small intestine was significantly higher in SAP group and MSC transplantation group than in control group (3.93 ± 1.08,2.13 ± 0.53 vs 0.68 ± 0.42 ; 2.44 ± 1.54,1.02±0.44 vs 0.60±0.14),the difference was statistically significant (F=21.772,F=6.132; P＜0.05).The expression of TNF-αmRNA and IL-1β mRNA in MSC transplantation group was lower than that in SAP group,the difference was statistically significant (P＜0.05).Compared with SAP group,pathological score indicated that small intestine injure was slighter in MSC transplantation group (3.83±0.28 vs 2.83±0.56),the difference was statistically significant (F=12.013,P＜0.05).Sry gene could be detected in the pancreatic and intestinal tissue of MSC transplantation group.Conclusion Allogeneic MSC transplantation group can inhibit Pro-inflammatory cytokines expression in acute pancreatitis,relieve the intestinal mucosa injury and may involve in the intestinal tissue repair.

Objective: To observe the effects of angina pector is on severe ventricular arrhythmia and QTd in patients with first acute myocard ial infarction(AMI). Methods: One hundred and eight-four cases of first AMI were divided into 2 groups: PA group, angina pectoris occurred with in 24 h before AMI onset (n=58), NPA group, no preceeding angina pectori s occurred (n=126). Occurrence of complications and QTd were investigated du ring hospitalization. Results: The basic clinical characteristic s, coronary risk factors, medication before infarction, treatments after admissi on with antiarrhythmic agents, site of infarction, successful rate of thrombolys is and peak CK, CK-MB were not statistically different. Early QTd in PA group and NPA group were (56.22±18.40) ms vs (84.45±21.90) ms, respectively, P <0.05, late QTd in PA group and NPA group were (50.67± 16.34) ms vs (64.1 8(16.41) ms, respectively, P<0.05. Comparison with NPA group, incidence of severe ventricular arrhythmia, heart failure, cardiogenic shock and rate of car diac mortality in-hospital was lower in PA group. Conclusion: P reinfarction angina pectoris can significantly reduce the incidence of severe ve ntricular arrhythmia and QTd in the patients with first AMI, sugges ting that these favorable effects might be associated with protective effects of ischemic preconditioning on myocardium and ventricular pump function and improv ement of repolarizative asynchronism in ventricular myocardium.

Objective: To investigate the efficacy and safety of naftopidil on patients with mild-to-moderate essential hypertension. Methods: A prospective, open study was performed in patients with hyp ertension. Forty patients were administered naftopidil for 8 weeks. Results:BP decreased significantly 2 weeks after administration an d reached to its trough at week 4. The magnitudes were 2.28 kPa (17.1 mmHg) and 1.43 kPa (10.7 mmHg) for SBP and DBP, respectively. The effect lasted to the end of experiment. HR had no change.The total effective rate was 82.05%.There was n o significant change in liver and renal function and electrocardiograph. Conclusion: Naftopidil has a stable hypotensive effect and the complia nce is good.