Objective To investigate the efficacy and feasibility of extra-peritoneal larparoscopic radical prostatectomy (eLRP) in the treatment of patients with high-risk prostate cancer (HRPC).Methods From February 2009 to December 2013,121 patients,who were diagnosed as HRPC according to the D'Amico definition,were received eLRP.The mean age was 70 years old (range 54 ～ 82 years old).The mean PSA level was 25.45 (range 2.40 ～ 111.31) μg/L and mean Gleason score was 8 (range 6 ～ 10).The classification of clinic stage in this study included 52 cases in cT1-cT2b,58 cases in cT2c,8 cases in cT3a,and 3 cases incT3b,respectively.The perioperative data were collected,including operative time,blood loss,intraoperative complications,urine leakage,lymph leakage,incontinent ability,erectile function and changing of PSA level.Results All the operations were successfully performed.The mean operative time was 165 minutes (range 105 ～341min),the average blood loss was 150 ml(range 50 ～ 1500ml).The intraoperative complications included hemorrhage in 4 cases and intra-operative obturator nerve injury in 3 cases.The mean duration of intestinal function recovery was 35h (range 24 ～72h) The mean interval of catheter indwelling was 9 days (range 7 ～14 days).The anastomotic leakage was found in 12 cases,including 1 day after surgery in 5 cases,2 days after surgery in 3 cases,3 days after surgery in 2 cases,4 day after surgery in 1 case and 5 day after surgery in 1 case.The anastomotic stricture in 3 cases within 2 to 4 months after operation,which the symptom improved after urethral dilation in 2 cases and urethrotomy in 1 case.Deep vein thrombosis was noticed in 1 case 5 days after the procedure.And lymphatic fistula was recorded in 1 case after the operation.Positive surgical margin,seminal vesicle invasion,and positive iliac vessel lymph node were found in 18,21,and 9 patients,respectively.The mean hospitalization duration was 10 days (range 5 ～ 22 d).Of the 107 patients followed-up,Ninety-six patients were continent in 1 year,except other 11 patients.Nerve sparing procedure was performed in 51 patients,and thirty-three of them were potent.The mean PSA level was 0.14 μg/L (range 0 ～8.75 μg/L) six weeks after the surgey.Fourty-eight patients had biochemical recurrence with 5 ～36 months followed-up,mean 18 months.Conclusions Extraperitoneal LRP is an efficacious approach for patients with high-risk prostate cancer.

Objective To study the clinical presentation and pathological features of rare nonepithelial vulvar tumors. Methods The clinical data of 42 patients with nonepithelial vulvar tumors who were operated on during 1986 to 2007 in Peking Union Medical College Hospital were analyzed. Results The average age of 42 patients was 44. 1 years. There were 32 eases (76%) with a vulvar mass. Twenty one of these 42 patients (50%) complained of associated symptoms of itch and pain Surgical treatment was the chief treatment of nonepithelial vulvar tumors, which included local excision (40, 95%), simple vulvectomy ( 1,2% ) and radical vulveetomy ( 1,2% ). Among the pathological diagnoses after operation,the most common benign histological subtypes were hidradenoma and haemangioma, while the must common malignant histological subtypes were leiomyosarcoma and aggressive angiomyxoma. Conclusions Most of the nonepithelial vulvar tumors are mesenehymal tumors. The clinical presentation has no special characteristics. Diagnosis of nonepithelial vulvar tumors can be made based on histological inspection.Surgical treatment is the treatment of choice.

Aim To investigate the effects of Sanjie Zhentong capsule on cultured mouse myometrial cell contraction induced by prostaglandin F2α( PGF2α) , and to elucidate the mechanism of Sanjie Zhentong capsule in treating dysmenorrheal. Methods Primary mouse myometrial cells were cultured and identified. Intracel-lular calcium ( [ Ca2+] i ) was monitored under a Flex-Station 3 Benchtop Multi-Modo Microplate Reader u-sing Calcium 6-QF. Myometrial cells were labeled to observe the changes of contraction. The expressions of calmodulin ( CaM ) , myosin light chain kinase ( ML-CK) , myosin light chain phosphorylation( p-MLC20 ) in mouse uterine smooth muscle cells ( USMCs ) were determined by immunofluorescence. Results Sanjie Zhentong capsule suppressed the intracellular[Ca2 + ]i inflow and reduced the areas of myometrial cells induced by PGF2α. Then it significantly decreased CaM and p-MLC20 levels. Conclusion Our results indicate that Sanjie Zhentong capsule has inhibitory effect on dysmenorrheal induced by PGF2α. Furthermore,its major mechanism may be related with the regulation of intracellular[ Ca2 + ]i inflow and the levels of CaM and p- MLC20.

Objective To detect the expression of Th17 pathway-related genes in patients with syphilis serofast reaction and to investigate the mechanism of Th17 cells in syphilis serofast reaction. Meth-ods Peripheral blood samples were collected from patients with syphilis serofast reaction ( n=8 ) , patients who were syphilis-seronegative after treatment (n=8) and healthy subjects (n=8). Total RNA was extrac-ted from each blood sample and then reversely transcribed into cDNA. PCR-Array analysis was performed to quantify the expression levels of Th17 pathway-related genes. Results The expression levels of genes with a fold change >2 (up or down regulated) were defined as differentially expressed. (1) Compared with the control group, the patients with syphilis serofast reaction showed increased expression of genes encoding fork-head box protein 3 (Foxp3) and IL-10, but decreased expression of genes encoding C-C motif chemokine 22 (CCL22), colony stimulating factor 2 (CSF2), CSF3, chemokine (C-X-C motif) ligand 6 (CXCL6), IL-17A, IL-17D, IL-21, IL-23R, IL-9, interferon regulatory factor 4 (IRF4), RAR-related orphan receptorα( RORα) , RAR-related orphan receptor γ ( RORγ) and signal transducer and activator of transcription 3 (STAT3). (2) Compared with the seronegative syphilis group, the expression levels of genes encoding Foxp3 and IL-10 in patients with syphilis serofast reaction were up-regulated, while the expression of genes encoding CCL22, CSF2, CSF3, IL-17A, IL-21, IL-23R, IRF4, RORγ and STAT3 were down-regulated. (3) The expression levels of genes encoding CXCL6 and IL-9 in seronegative syphilis group were lower than those in control group. Conclusion The abnormal expression of Th17 pathway-related genes might relate to the pathogenesis of serofast state of syphilis.

Objective To study the therapeutic effect and safety of recombinant human growth hormone in short children born small for gestational age (SGA).Methods Twenty-two short children born SGA were randomly divided into 2 groups and were exposed to different doses of recombinant human growth hormone,which were low dose group [0.1 IU/(kg · d)] and high dose group [0.2 IU/(kg · d)].Treatment was carried out for 2 years.Before and after treatment,height,weight,bone age,insulin-like growth factor 1 (IGF-1),insulin-like growth factor-binding protein 3 (IGFBP-3),growth rate (GV),height standard deviation scores (HtSDS),predicted adult lifetime height (PAH),fasting and postprandial blood glucose,insulin,thyroid stimulating hormone (TSH),T3,T4,and glycosylated hemoglobin were measured.Results Basic value of growth hormone in SGA infant was (2.94 ± 3.27) μg/L.Two years after treatment of growth hormone in high dose group,growth rate [(8.11 ± 1.31) cm/year vs (4.21 ± 0.99) cm/ year],HtSDS(-1.16 ±0.83 vs-3.00 ±0.71),and PAH[(163.68 ±6.76) cm vs (156.54 ±7.39) cm] were significantly higher than those before treatment (F =110.3,30.47,26.20,all P ＜ 0.01).Similar changes were observed in low dose group except for PAH.In high dose group after 2 years of treatment,IGF-1,IGFBP-3 were significantly higher than those before the treatment and the difference was statistically significant (all P ＜ 0.05).Although the plasma levels of IGF-1 and IGFBP-3 in low dose group in 2 years of treatment were significantly higher than those before the treatment,the difference was not statistically significant (P ＞ 0.05).Compared with that before treatment,the added value of IGF-1 had a positive correlation with the added values of growth rate,HtSDS and PAH(r =0.567 4,0.652 4,0.584 3,0.499 8,all P ＜ 0.05).Similar observations were found in low dose group (r =0.437 1,0.405 6 and 0.501 1,all P ＜ 0.05).However,the added value of IGF-1 in low dose group had no correlation with PAH (r =0.200 8,P ＞ 0.05).Compared with that before treatment,2 groups had no differences in fasting and postprandial blood glucose,insulin,TSH,T3,T4 and glycosylated hemoglobin (all P ＞ 0.05).Conclusions Recombinant human growth hormone [0.20 IU/(kg · d)] may significantly increase the growth rate and PAH of short children born SGA,which is a safe and effective strategy for the treatment of short SGA.

AIM: To study and establish the fingerprint of raw Herba Polygoni Orientalis by RP-HPLC. METHODS: The chromatographic conditions were as follow: an Inersil-ODS-3 column was used;the mobile phase was composed of acetontrile and 0.1% phosphoric acid with gradient elution;the flow was 1.0 mL?mim~(-1) and the UV absorbance detection was set at 300 nm. RESULTS: Under the selected chromatographic conditions. Similarity of 10 batches of good HPLC fingerprint of raw Herba Polygoni Orientalis were obtained. no less than 0.9.( CONCLUSION): Quality of raw Herba Polygoni Orientalis can be controlled effectively by HPLC-UV fingerprint.

Objective To investigate the effect of CT perfusion (CTP) imaging guidance in the treatment of acute cere?bral infarction. Methods Patients (n=200) with acute cerebral infarction who visited our clinic within 6 hours underwent CTP examination and were divided into two groups:penumbra group and non-penumbra group according to their CTP imag?ing (presence of penumbra or not). Recombinant tissue plasminogen activator (rt- PA) was administrated for intravenous thrombolysis in both groups. NIHSS (The NIH Stroke Scale), BI (Barthel Index), mRS (modified Rankin Scores) and hemor?rhagic transformation events of two groups were determined before and after thrombolysis to evaluate its effect and prognosis in these two group. Results Compared with non penumbra group, NIHSS was reduced in penumbra group from 7 days after rt-PA (6.67±3.46 vs 4.76±2.04), and this decrease became obvious at 4 weeks after rt-PA (6.67±3.46 vs 3.68±1.93). Effi?ciency rate at 4 week (60.3%) and good prognosis rate at 3 months(71.7%)were both significantly improved in penumbra group than those in non penumbra group(34.7%,56.8%). Conclusion rt-PA under CTP guidance is effective and safe in the treatment of acute cerebral infarction. The thrombolytic therapy window can be enlarged according to the presence of pen?umbra or not and the bleeding conversion rate remains at low level.

Objective To determine the genetic polymorphisms of DC-SIGN and DC-SIGNR among HIV negative Chinese female sex workers. Methods The 69 bp tandem repeat numbers in exon 4 of the DC-SIGN and DC-SIGNR were examined by PCR in 234 HIV-1-seronegative female commercial sex workers. Results It was found that 4 of 234 individuals were heterozygous in DC-SIGN. For DC-SIGNR, the allele frequencies were seven times repeated in 65.2%, 5 in 18.4%, and 9 in 11.9%. Those patterns of alleles frequencies were significantly different compared with those reported in the Caucasians residing in Europe. Conclusion Polymorphisms of DC-SIGN repeat region seem to be infrequent in Chinese female sex workers and those of DC-SIGNR are different from what reported in other races.

Objective To evaluate clinical efficiency and quality-of-life outcomes in treatment of severe pelvic organ prolapse by the Xiehe pelvic floor reconstruction surgery. Methods From Jun. 2006 to Dec. 2008, 277 severe pelvic organ prolapse patients with stage Ⅲ to Ⅳ from 8 hospitals in China were enrolled in this prospective study. Pelvic organ prolapse quantitative examination (POP-Q) and anatomic improvement in these patients after surgery were analyzed in this interim study. Comparisons of pelvic floor impact questionnaire-short form 7 (PFIQ-7) and pelvic floor distress inventory-short form 20 (PFDI-20) in these patients before and after surgery was used to evaluate quality of life. Comparison of pelvic organ prolapse-urinary incontinence sexual questionnaire (PISQ) in these patients before and after surgery was used to evaluate quality of sexual life. Results With a median follow-up of 14. 0 months (6 -28 months),twenty-three patients showed recurrent prolapse (8. 3%, 23/277), and anatomical success ( ＜ stage 2 in the treated compartment) was 91.7% (254/277). In this series, mesh exposure or erosion rate was 6. 9% (19/277). The postoperative de novo stress incontinence rate was 6. 5% (18/277). The scores for PFIQ-7 and PFDI-20, and its subscales were significantly improved, the scores of before treatment were lower than those after treatment (P ＜0. 01 ). And there was no significant difference in the average score of PISQ before and after the surgery (76. 6 ± 15.4 versus 75.5 ± 14. 5 versus 73.6 ± 12. 6, P ＞0. 05 ), but the rate of de novo dyspareunia was 11% (9/80). Conclusions Xiehe pelvic floor reconstruction surgery was safe and efficacy in treatment of pelvic organ prolapse. It could improve quality of life remarkably with less cost when compared with the traditional total pelvic floor reconstruction surgery.

Objective To analyze the status quo of sexually transmitted diseases (STDs) of the elderly in recent years in Shenzhen, to explore the characteristics of temporal and spatial distribution,and to establish prediction model of STDs of the elderly in Shenzhen. MethodsUsing the surveillance system data of STDs from 2005 to 2009 in Shenzhen city, the incidence, temporal and spatial distribution of syphilis and gonorrhea were analyzed in the elderly aged 50 years and over by SaTScan. The incidence prediction model of STDs was established by Eviews 5.0.Results (1)The incidences of the two kinds of STDs from 2005 to 2009 in Shenzhen were on the rise and on more marked increase in male than in female. The rising velocity in over-60 year age group was similar with in 50-59 year age group. The rising velocity of syphilis was faster than gonorrhea. (2)The space-time distribution analysis showed there were clusters of the STDs in elderly men in 2005 in Lianhua and Meilin districts (P = 0. 026, RR= 2.13). (3) ARIMA (0, 1,1) (0,0, 1) 12 model was a suitable forecasting model for STDs in elderly men in Shenzhen. Conclusions