Objective To evaluate the diagnostic valu e of ~131I-MIBG adrenomedullary scintigraphy for high blood cat echolamine. Methods 96 cases of high blood catecholamine and 197 cases of other diseases were screened with ~131I-metaiodo benzylguanidine(MIBG) adrenomedullary scintigraphy. Results 56 cases of the total 60 cases of pheochromocytoma and 33 cases of the total 36 cases of adrenomedullary hyperplasia showed positive image. The positiv e rate were 93.3% and 91.7% respectively. 138 cases of primary hypertension, 4 9 cases of adrenal and other organic tumor, 4 cases of pheochromocytoma befor e operation, 10 cases of cured pheochromocytoma after resection and 3 cases of adrenomedullary hyperplasia all showed negative image. The total positive rate for high blood catecholamine was 92.7%, which was much higher than other method s, such as biochemical assay, type B ultrasound, computer tomography and magneti c resonance image. Conclusions ~131I-MIBG w as of great value for the locative and qualitative diagnosis of high blood catec holamine,especially for the silent, ectopic and multiple pheochromocytoma, the m etastatic malignant pheochromocytoma and adrenomedullary hyperplasia. It could be used for the differential diagnosis of high blood catecholamine from primary hypertension and other kinds of tumors.

Objective To investigate the effect of As2 O3 in combination with cinobufacini on proliferation and apoptosis of the K562 cells and provide theoretical basis for clinical application.Methods Cell proliferation was assayed by analyzing the growth and viability of the cells.Apoptosis was assayed by performing cell morphology,Annexin-V/PI staining,DNA-PI staining,and DNA gel electrophoresis.Results After exposure to As2O3 and cinobufacini,the growth of K562 cells was inhibited and the viability of K562 cells was decreased. After treated with 1.0μmol/L As2O3,0.125μg/ml cinobufacini,0.25μg/ml cinobufacini,1.0μmol/L As2O3 + 0.125 μg/ml cinobufacini,1.0μmol/L As2O3 + 0.25μg/ml cinobufacini for 24 and 48 hours,the proliferation inhibition rate were(24 ± 1.3)%,(21 ± 1.5)%,(38 ± 3.1)%,(57 ±2.7)%,(66 ±3.3)% and(49 ±2.9)%,(48 ±2.7)%,(61 ±2.1)%,(77 ±3.8)%,(82 ±4.2)%,the apoptosis rate of K562 cells were(4.8 ± 0.5)%,(5.6 ± 0.7)%,(9.8 ± 0.6)%,(11.9 ± 1.2)%,(15.2±1.5)% and(11.0 ±0.9)%,(12.9 ±1.1)%,(18.4 ±1.5)%,(21.0 ±2.0)%,(28.0 ±1.9)%.The percentage of apoptotic cells was a time- and dose-dependent manner.Typical DNA ladder was shown by DNA gel electrophoresis.Conclusions As2O3 combined with cinobufacini inhibited the proliferation of K562 cells and induced apoptosis of the K562 cells,the combination of the two drugs had better effect.

Objective To analyse the operation technique and therapeutic effect of "inserting" uretero-intestinal anastomosis in orthotopic bladder substitution.Methods Thirty-eight patients undergoing orthotopic bladder substitution operations were followed up,and the way of uretero-intestinal anastomosis in all Datients was the "inserting"uretero-intestinal anastomosis.The therapeutic effect was observed by radiation,cystoscopy,pathologic biopsy and blood test.Results The average follow-up time was(3 1.65±14.14)montll8.and the stricture rate was 4%(3/75),but no vesicoureteric reflux was found.The rate of leakage was 0.Nipples were formed at the site of anastomosis under the view of cystoscope,and among the 7 patients whose nipples were taken to be examined by histology,2 cases were intestinal epithelium which were taken at the base of nipple8.while the others were transitional epithelium which were taken at the top of nipples.The renal function of all patients was normal (Cr 54-135 μmol/L,BUN 3.2-9.4 mmol/L).Conclusion "Inserting"uretem-intestinal anastomosis is an ideal antireflux uretero-intestinal anastomosis method.

Purpose:To investigate the prognostic value of P-glycoprotein(Pgp), mutant P53 protein and epidermal growth factor receptor (EGFR) expression in primary superficial transitional cell carcinomas(TCCs) of bladder.Methods:Specimens from 46 patients with untreated superficial bladder TCCs were analyzed for the expression of Pgp,mutant P53 and EGFR respectively and their clinical data were obtained by follow-up for over 3 years.Results:Pgp, mutant P53 protein and EGFR were positive in 45.7%,58.7% and 52.2% respectively. A strongly inverse relationship between the expression of Pgp, mutant P53 and EGFR and disease free survival (DFS)could be demonstrated by Kaplan Meier survival analysis. Multivariate analysis(Cox regression)indicated that DFS or recurrence was associated with overexpression of Pgp and mutant P53 protein, no significant correlation between EGFR overexpression and recurrence was found.Conclusions:Overexpression of Pgp, mutant P53 can be used as the important prognostic factor of recurrence of superficial TCCs.

Objective To evaluate the efficacy of mitomycin (MMC) intravesical chemotherapy for superficial bladder carcinoma by in vitro chemosensitivity using histoculture drug response assay (HDRA).Methods Forty-one cases of superficial bladder transitional cell carcinoma(TCC) were obtained,including 30 males and 11 females with mean age of 55 years.Of them,10 cases were Ta and 31 were T1 according to TNM stage system (UICC 2002) while 9 cases were G1,22 were G2 and 10 were G3 (WHO1973).All cases had no chemotherapy history before operation and were operated to retain bladder.Tumor specimens were cultured by three-dimensional histoculture.HDRA with im-proved MTT assay was utilized for chemosenstivity test of MMC with 1 g/L concentration and 2 hours exposure.Growth inhibition rate (GI) exceeding 70% was defined as high-sensitive while less than 50% GI was defined as insensitive,others were moderate-sensitive.All cases were performed standard intravesical chemotherapy with MMC 40 mg plus 40 mt saline.Every case was followed up every 3 months.The patients were followed up for 5 years or untill recurrence.Results The MMC chem-osensitivity was different among 41 patients.Thirteen cases were insensitive including 1 of Ta,12 of T1 (P=0.009) and 1 of G1,7 of G2,5 of G3(P=0.101).Total recurrence rate was 39%(16/41) af-ter 3 to 5 years follow-up.There were 1 of Ta,15 of T1 (P=0.059) and 10 of G2 6 of G3 (P=0.016).Insensitive group recurrence rate was 77% (10/13) while sensitive group was 21% (6/28,P= 0.004).Patients in sensitive group showed a longer median time(49.2 months) than patients in insen-sitive group (16.5 months,P<0.001) according to Kaplan-Meier analysis with Log-rank test.The MMC chemosensitivity was independent prognostic factor examed by Cox regression analysis (P= 0.008).There was a 78% correlation rate of chemosensitivity by HDRA to clinical effect of MMC in-travesical chemotherapy.Conclusion HDRA could evaluate MMC intravesical chemotherapy for su-perficial bladder TCC,improve therapeutic effect and lower tumor recurrence rate.

Objective To investigate the expression levels and significance of hypoxia inducible factor-1 α (HIF-1 α),vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) in pathological scar.Methods 73 patients with pathological scar from March 2015 to February 2017 in our hospital were selected,including 42 cases in hypertrophic scar group and 31 cases in keloid group.20 cases of non pathological scar patients and 20 cases of normal plastic surgery were selected as control group.mRNA and protein expression levels of HIF-1,VEGF and MMP-2 in skin tissue of each group were detected by real-time fluorescence quantitative and Western blot,and the clinical significance was analyzed.Results Compared with non pathological scar tissue and normal skin tissue,the mRNA and protein expression levels of HIF-1α,VEGF and MMP-2 in pathological scar tissue were significantly increased,and the differences were statistically significant (P ＜ 0.05).The mRNA and protein expression levels of HIF-1α in keloid group were significantly higher than those in hypertrophic scar group (P ＜ 0.05);there was no significant difference in the expressions of mRNA and protein of VEGF between keloid group and hypertrophic scar group (P ＞ 0.05);the mRNA and protein expression levels of MMP-2 in keloid group were significantly lower than those in hypertrophic scar group (P ＜ 0.05).Pearson correlation analysis showed that there was a significant positive correlation between HIF-1α and VEGF,MMP-2 in pathological scar tissues (r =0.623,0.507,P ＜ 0.05).Conclusions The expressions of HIF-1α,VEGF and MMP-2 in pathological scar tissue is obviously increased,which is closely related to the formation of pathological scar.