Objective To study the effect of finasteride on preventing prostate hyperplasia with acute urinary retention.Methods Totally 626 patients with benign prostatic hyperplasia (BPH) were randomly divided into treatment group (316 cases) and control group (310 cases),followed up for 3 years.The incidence of acute urinary retention and prostate volume changes were analyzed.Results There were 3 cases of acute urinary retention in treatment group (1.0 ％),9 cases in control group (2.9％) (x2 ＝5.37,P＜0.05).In treatment group,the average prostate volume was reduced about 23.6％ compared with before taking the medicine,on the contrary,prostate volume was averagely increased 12.3％ in control group.Conclusions Finasteride can reduce the risk of acute urinary retention by narrowing the prostate volume in patients of benign prostatic hyperplasia.

ObjectiveTo study the feasibility,safety and efficacy of laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy for adult congenital choledochal cyst.MethodA retrospective study was conducted on 7 adult patients with congenital choledochal cyst who received total laparoscopic cyst excision and Roux-en-y hepaticojejunostomy from May 2008 to February 2011 in the Department of General Surgery of Shengjing Hospital,China Medical University.ResultsAll the laparoscopic surgery was successful.The mean operation time was 210 minutes.The average intraoperative blood loss was 80 ml.All patients were out of bed within the first 24 h after surgery.The mean time to first flatus/bowel motion was 2.4 days.Except 1 patient who had small amount of bile leakage,all patients recovered smoothly without any major postoperative complications.The average hospital stay was 8.1 days.No patients suffered from abdominal pain,fever or jaundice during follow-up from 3 to 30 months.ConclusionTotal laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy was a safe,efficacious,and minimally invasive procedure.

ObjectiveThrough the examination of Clostridium difficile (Cd) in the stool of inflammatory bowel disease (IBD) patients to investigate its infection status in IBD patients and the relationship with IBD.MethodsFrom December 2009 to January 2011,a total of 130 diagnosed IBD patients were collected in the Department of Gastroenterology,Ruijin Hospital,Shanghai Jiaotong University School of medicine,including 60 ulcerative colitis (UC) patients and 70 Crohn's disease (CD) patients.At same time.60 irritable bowel syndrome patients and 60 healthy volunteers were collected as control.Stool samples were tested by PCR and Cd toxin A/B test kit (CDTK).SPSS statistical software was used for statistical analysis.ResultsIn 130 enrolled IBD patients,16 cases (12.3％) were Cd infected,of which 10 were UC cases (16.7％) and 6 were CD cases (8.6％).No Cd infection was found positive in control group (x2 =15.779,P=0.000).The infection rate of Cd in the patients of active stage was higher than that in the patients of inactive stage (x2 =10.092,P=0.001).The infection rate of coion-type CD patients was 4/14,which was significantly higher than those of other types CD patients (x2 =13.125,P=0.001).The infection rate of Cd was 4.5％ in mild UC patients,14.3％ in moderate and 6/17 in severe (x2 =6.667,P=0.037) ; the infection rate were 0％ in mild CD patients,4.2％ in moderate and 5/16 in severe.The infection rate increased along with the increase of The disease severity (x2 =13.907,P=0.000).There was no significant difference in the infection rate of Cd between broad-spectrum antibiotics used and not used patients (x2 =1.414,P =0.378), or between patients with broad-spectrum antibioticsused aloneand combinedwith immunosuppressant (x2 =0.330,P=0.962).ConclusionsThere was certain infection rate of Cd in IBD patients,especially the patients in active stage. The infection rate increased along with the increase of the IBD severity.

Objective To analyze the common and individual training needs of palliative care among nurses in different level hospitals. Methods The self-designed questionnaire about training needs of palliative care was used to investigate 340 nurses in different level hospitals. The data were analyzed by Ridit analysis method. Results There were 24 important items and 26 unimportant items in the common training needs. Regarding the individual training needs,the concept of palliative care,basic nursing care and bereavement support were preferred by the primary-level hospital nurzes,while the principles of palliative care,basic nursing care and pain management in secondary-level hospital nurses,radiotherapy and chemotherapy care and the ethical and moral problems in palliative care in third-level hospital nurses. Conclusion Different level hospital nurs-es have beth common and individual needs in the training contents of palliative care. Ridit analysis can distinguish the differ-ences and provide reference for the training.

Objective:To explore the cerebral hemodynamic changes of patients with hypertension complicated reti-nopathy.Methods:A total of 77 patients with hypertension complicated retinopathy were enrolled as study group, another 70 patients,who received physical examination during the same period and its results were normal,were treated as normal control group.Index changes of middle cerebral artery (MCA)and anterior cerebral artery (ACA)were compared between two groups,and hemodynamic difference of ophthalmic artery (OA)and central retinal artery (CRA)were recorded.Results:Compared with normal control group:① Mean velocity of MCA and ACA [(64.28±13.29)cm/s,(20.12±7.21)cm/s vs.(129.18±20.14)cm/s,(89.35±10.98)cm/s]signifi-cantly rose in study group ,P <0.01 all;②There were significant reductions in peak systolic velocity (PSV)and end-diastolic velocity (EDV)of OA and CRA,P <0.05 all,and resistance index significantly rose in all classes of study group (P <0.05 all);③There were significant reductions in mean blood flow velocity [(21.62±7.36)ml/s vs.(13.47±5.13)ml/s],maximum blood flow velocity and minimum blood flow velocity ,and significant rise in pulse wave velocity,peripheral resistance,critical pressure,vascular characteristic impedance [(17.35±5.36)kPa ·s-1 ·m-1 vs.(31.68±6.47)kPa· s-1 · m-1 ],and dynamic resistance [(30.59 ± 6.98)kPa· s-1 · m-1 vs. (64.48±12.38)kPa·s-1 ·m-1 ],in basilar artery in study group,P <0.01 all.Conclusion:In patients with hy-pertension complicated retinopathy,cerebral blood supply indexes reduce along with blood pressure rises,CRA blood flow changes can be regarded as a judging basis for disease course development,which deserves highly atten-tion for patients and physicians.

Objective To investigate the effects of adenovirus vectors for BTB and cap'n'collar protein homology 1 (Bach1) small interfering RNA (siRNA) on antioxidanffactors and fibrosis related cytokines in lung fibroblasts (MLF) in transforming growth factor (TGF)-β1 induced mouse.Methods Bach1 siRNA recombinant adenovirus vectors and blankadenovirus vectorwere constructed,then the MLF cells were incubated with TGF-β1 (5 ng/ml) for 24 h and infected with blankvector and successful constructed Bach1 siRNAs.The messenger RNA (mRNA) and protein expression of Bach1,heme oxygenase (HO)-1,glutathione peroxidase 1 (GPx1) and nicotinamide-adenine dinucleotide phosphate:quinone oxidoreductase-1 (NQO1) in cell supernatants were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot.Changes of fibrosis-related cytokines including TGF-β1 and interleukin (IL)-6 levels in cell supernatants were determined by enzyme-linked immunosorbent assay (ELISA).One-way analysis of variance (ANOVA) was performed for multiple group comparisons and LSD test was used to compare the two groups.Results Bach1 mRNA (2.127±0.089) and protein expression increased significantly after TGF-31 stimulation compared with blank group (1.000±0.067,t=-21.77,P＜0.01),as well as the expression of fibrosis-related cytokines TGF-β1 (52±6) and IL-6 (34±6) in cell supernatants increased significantly after TGF-β1 stimulation compared with blank group (26±4,t=-11.11,P＜0.01 and 20±5,t=-5.32,P＜0.01),but the mRNA expression of HO-1 and GPx1 (0.403±0.040 and 0.567±0.112) also the protein expression decreased significantly compared with mRNA (1.000±0.181,t=25.57,P＜0.01 and 1.000±0.212,t=6.68,P＜0.05) and protein expression in blank group.Follow the Bach1 siRNA treatment,Bach1 mRNA (0.153±0.015) and protein levels were significantly downregulated compared with mRNA (2.129±0.089 and 1.973±0.035,F=1835.95,P＜0.01) and protein expression of TGF-β1 and blank vector group,as well as TGF-β1 (26±3) and IL-6 (11±3) expression in cell supernatant were significantly inhibited compared with TGF-31 (52±6 and 34±6) and blankvector group (49±5 and 33±6) (F=22.25,P＜0.01 and F=28.38,P＜0.01).But the mRNA levels of HO-1 (3.303±0.294) and GPx1 (1.840±0.231) in MLF were promoted significantly compared with TGF-β1 (0.403±0.040 and 0.567±0.112) and blank vector group (0.353±0.057 and 0.667±0.090) (F=53.90,P＜0.01 and F=526.25,P＜0.01).Conclusion Silencing Bach1 rescues TGF-β1 induced reduction of antioxidants and increasethefibrosis in MLF cells.The study offers an experimental basis to explore pathogenesis of oxidative stress and antioxidant therapy for connective tissue disease related inter-stitial lung disease.

In recent years, w ith the w idespread use of advanced neuroimaging techniques and the aging of the population, more and more asymptomatic smal unruptured intracranial aneurysms (sUIAs) are incidentaly detected in clinical practice. Studies have show n that the prevalence of unruptured intracranial aneurysm (UIA) is 2%-3% in adults, and more than 2/3 of them are smal aneurysms of < 7 mm in diameter. Usualy these sUIAs do not have any symptoms and the risk of rupture is low er. They are also know n as incidental or asymptomatic aneurysms, but they are not w ithout the risk of rupture. At present, there is no unified opinion about w hether to conduct conservative treatment or surgical clipping or endovascular interventional therapy. This article review s the latest research progress of sUIAs ( < 7 mm in diameter), hoping to provide more evidence for clinical assessment, decision -making, and individual treatment of this kind of aneurysms.

AIM: To study whether Sca-1 + cells from fetal liver can be induced to differentiate into neuronal cells in vitro. METHODS: Sca-1 + cells from 14 5-days-old murine fetal liver were isolated with a magnetic cell sorting kit, and were cultured in Dulbecco's modified Eagle's medium (DMEM)/F12 supplemented with 10% fetal bovine serum (FBS), and passaged at a ratio of 1∶3 when cells reached more than 80% confluence. The 5 passage cells were induced by 10 -3 mol/L ?-mercaptoethanol (?-ME) and 5 ?10 -7 mol/L all-trans-retinoic acid (RA) for 24 hours, and then incubated in serum-free medium for 5 hours to 5 days. The characteristics of treated cells were assayed by immunocytochemistry staining analysis at 5 hours, or 5 days.RESULTS: Cells treated with ?-ME and RA exhibited neuronal phenotype and expressed neuron-specific protein such as neuron-specific nuclear protein (NeuN), neuronfilament-M, and neuron-specific tubulin-1 (TuJ-1) but not tau, MAP-2, or the astrocyte-specific marker glial fibrillary acidic protein (GFAP).CONCLUSION: Sca-1 + cells from fetal liver, of which most are regarded as hematopoietic stem cells, could differentiate into early immature neuronal cells in vitro . These findings suggest that Sca-1 + cells from fetal liver may be an alternative source in cell therapy and gene therapy of neural dysfunction.

AIM: To investigate the effects of ?-mercaptoethanol (?-ME) and all-trans rentinal acid (RA) on glial fibrillary acidic protein (GFAP) expression in mesenchymal cells derived from mouse fetal liver in vitro. METHODS: Cells suspension from 14.5-days-old mouse fetal liver were cultured in DMEM/HEPES/F12 supplemented with 20% FCS and mesenchymal cells were acquired after discarding nonadherent cells. The 5th passage cells were induced by ?-ME and RA. The characteristics of treated cells were assayed by immunocytochemistry staining at 5 hours and 5 days after induction. ?-actin as an internal control, GFAP gene expression of mesenchyal cells was detected with semi-quantitative RT-PCR. RESULTS: After being inducted by ?-ME and RA, 80% approximately of the cells exhibited typical neural morphology and about 85% expressed GFAP phenotype. Semi-quantitative RT-PCR showed that mRNA expression of GFAP increased in treated cells versus untreated cells (P