ObjectiveTo investigate the effects of comprehensive geriatric assessment (CGA) intervention on depression and anxiety in patients with benign prostatic hyperplasia (BPH).Methods90 patients with BPH (aged 65 years and over) from June 2009 to June 2010 were randomly assigned to control(n= 45) and CGA (n = 45) group.Control group received conventional therapy,while CGA group was given CGA and consultation therapy as well as conventional therapy.The scores of international were assayed and compared between two groups before and 6 months after treatment.ResultsThe scores of international prostate symptom score (IPSS),quality of life scale (QOLS),self-rating depression scale (SDS) and self-rating anxiety scale (SAS) in control (t= 11.0,5.84,7.08and 9.68,respectively) and CGA (t= 14.0,10.4,9.16 and 6.1,respectively)group 6 months after treatment reduced as compared with those before treatmen (all P ＜ 0.01).After 6 months of treatment,the scores of IPSS,QOLS,SDS and SAS in CGA group were lower than in control group (t= 4.25,5.55,3.45 and 2.88,respectively,all P＜0.01).ConclusionsCGA intervention can improve the quality of life in BPH patients and alleviate their depression and anxiety.

Objective To investigate induction effect of AGE on oxidative stress and type Ⅰ ,Ⅲcollagen synthesis in rat cardiac fibroblasts and interference effect of RGZ during the course. Methods Incubate rat cardiac fibroblasts with AGE of different concentration ,add RGZ to interfere for 48 h ,and then collect supernatant fluid .Superoxide dismutase (SOD) activity and malondialdehyde (MDA) content were detected by SOD kit and MDA kit separately ,and type Ⅰ ,Ⅲ collagen contents were measured by ELISA. Results When incubating cardiac fibroblasts with RGZ and 200 mg/L AGE together for 48 h , with the rise of RGZ concentration(0.1 ,1 and 10 mol/L) ,SOD activity in the supernatant fluid of cultured cardiac fibroblasts gradually increased [(21.564 ± 1.614) ,(22.323 ± 1.260) ,(23.661 ± 1.562) vs (19.320 ± 0.896) nU/ml ,P<0.05 or P<0.01] ,MDA content gradually decreased [(1.325 ± 0.048) ,(1.279 ± 0.032) ,(1.229 ± 0.045 ) vs (1.629 ± 0.043 ) nmol/ml ,P< 0.01 ] and type Ⅰ ,Ⅲ collagen Contents gradually decreased [(79.17 ± 3.25) ,(60.42 ± 3.58) ,(42.71 ± 5.11) vs (85.54 ± 2.28) ng/ml ,P<0.01 ;(37.52 ± 3.43) ,(27.09 ± 4.75) ,(20.81 ± 3.26) vs (40.75 ± 2.70) ng/ml ,P<0.01] as compared with 200 mg/L AGE group. Conclusion AGE can induce oxidative stress in cardiac fibroblasts and increase type Ⅰ ,Ⅲ collagen contents .RGZ can inhibit oxidative stress in cardiac fibroblasts and synthesis and secretion of type Ⅰ ,Ⅲ collagen induced by AGE. This finding indicates that RGZ may play an important role in the prevention of diabetic myocardial fibrosis.

At present, the computer administration and network system for diabetes still need exploration in China. A management software for the prevention and treatment of diabetes has been developed, taking the advanced MS SQL SERVER system as background database, while PowerBuilder 9.0 as foreground development tool. Both personal version and net version are configurable at random. This software includes six parts, namely the general data of patients, conventional physical examination of patients, treatment proposal, knowledge management, data query and statistical analysis, and system maintenance, in which they contact and conjugate with each other for the convenience of the whole processing. Good effects are obtained in the practical application of this software, and a regional network of the preventive and therapeutic information for diabetes is set up combining with other medical units, which can share the individual information, improve the ability of cooperative and follow-up study of diabetes, promote the data transferring and diagnosing quality of primary medical services, and is beneficial for both patients and physicians.

Objective To investigate the therapeutic effects and safety of beraprost sodium on vascular endothelial dysfunction in elderly patients with lower extremity arteriosclerotic occlusive disease (LEAOD).Methods A total of 80 patients with LEAOD were randomly divided into 2 groups:the treatment group and the control group (n=40 each group).All patients were treated with conventional antihypertensive,antidiabetic,hypolipidemic,antiplatelet drug therapy and non-drug therapy such as smoking cessation,foot care.In addition,patients in the treatment group received 40 μg oral beraprost sodium at a dose of 120 μg/day,3 times/day for 30 days.The changes in symptoms,vital signs,the function of liver and kidney,hemorheology,and serum nitric oxide (NO)were observed before and after the treatment.Results No adverse reactions happened among all patients.After 30 days treatment,there was a significant difference in the total efficacy between the treatment and control groups (80％ vs.35％,x2 =19.60,P＜0.01).The levels of plasma viscosity,erythrocyte aggregation index and serum NO in the control group were (1.70±0.19) mpas.s,5.69±1.08,(43.86±5.20) μmol/L,respectively before the treatment and (1.36±0.14) mpas.s,3.23±0.67,(56.84 ± 7.05) μmol/L,respectively after the treatment.The levels of plasma viscosity,erythrocyte aggregation index and serum NO in the treatment group were (1.71 ±0.18) mpas.s,5.70±1.04,(44.24±5.40) μmol/L,respectively before the treatment and (1.10±0.12) mpas.s,2.80 ±0.52,(64.00±8.15) μmol/L,respectively after the treatment.Compared with pretreatment,the levels of plasma viscosity and erythrocyte aggregation index in the two groups were significantly decreased and serum NO level was increased after the treatment (t=9.07,12.17,17.85,15.76,9.38,12.78,respectively,all P＜0.05).Compared with the control group,the levels of plasma viscosity and erythrocyte aggregation index in the treatment group were significantly decreased and serum NO level was increased (t =8.91,3.27,4.21,all P＜0.05).Conclusions The oral beraprost sodium can effectively and safely improve the hemorheologic and endothelial function in elderly patients with LEAOD.

To apply preventive T-shaped enterostomy in protective defunctioning stoma.Technique of enterostomy closure was only made in abdominal wall rather than abdominal cavity.A total of 78 patients undergoing protective ostomy from January 2005 to April 2012 were divided into two groups of routine enterostomy (group A,n =52) and protective T-shaped enterostomy (group B,n =26).The length of operation and average hospital stay in group A with stoma closure were(98 ± 16) min and (15.3 ± 5.2)days while those of group B (52 ± 9) min and (9.5 ± 2.3) days.The inter-group differences were statistically significant respectively (P ＜ 0.05).Therefore protective T-shaped enterostomy,showing advantages in operative skills,operative trauma and postoperative recovery time,is an effective technique and its application should be further promoted.

BACKGROUND: Homocysteine (HCY) has been verified as an independent risk factor of atherosclerosis and atherothrombosis of cardiovascular disease.OBJECTIVE: To observe the effects of HCY on the secretion and activity of matrix metallopotinase-1 (MMP-1) and tissue inhibitors of metalloproteinase-1 (TIMP-1) in vascular smooth muscle cells (VSMCs).DESIGN : Auto-control observation.SETTING: Pathology Room, Institute of Regeneration Medical Sciences, Jilin University.MATERIALS: In vitro cultured vascular smooth muscles cells (VSMCs) of rats were obtained from male Wistar rats with the body mass of about 150 g from weeks 4-6 supplied by Laboratory of Animals, Norman Bethune Medical Sciences Division, Jilin University.METHODS: The experiment was performed at the Pathology Room, Institute of Regeneration Medical Sciences, Jilin University from May 2001 to May 2003. VSMCs ofin vitro cultured rats were adopted and divided into 5 groups, 0(control group), 0.10, 0.25, 0.50 and 1.00 mmol/L HCY were added, respectively for 48 hours. Effect of HCY on activity of MMP-1 was observed with zymography. The secretions of MMP-1 and TIMP-1 and their mRNA expressions were studied with Western blot and semi-quantitative reverse transcription polymerase chin (RT-PCR).MAIN OUTCOME MEASURES: Activity of MMP-1, secretions of MMP-1 and TIMP-1 and their mRNA expressions.RESULTS: ①Secretions of MMP-1 and TIMP-1: The secretion of MMP-1 in the 0.25, 0.50 and 1.00 mmol/L HCY groups was lower significantly than that in the control group (P ＜ 0.05-0.01). The secretion of TIMP-1 in the 0.10, 0.25, 0.50 and 1.00 mmol/L HCY groups was higher than that in the control group (P＜ 0.05-0.01). ②The MMP-1 activity decreased with the increase of HCY, but reduced obviously in the 0.50 and 1.00 mmol/L HCY groups (P ＜ 0.01). ③The expression of MMP-1 mRNA in the 4 HCY groups was lower markedly than that in the control group (P ＜ 0.01). The expression of TIMP-1 mRNA in the 0.25 mmol/L HCY group was higher than that in the control group (P ＜ 0.05), and it was higher remarkably in the 0.50 and 1.00 mmol/L HCY groups than that in the control group (P ＜ 0.01).CONCLUSION: HCY can inhibit enzyme activity, decrease collagen degradation and induce collagen accumulation by inhibiting the secretion of MMP-1, which indicates that reduction of collagen degradation induced by HCY is one of the pathogenesies of atherosclerosis.

ObjectiveTo investigate the amount of bacteria and the expression of amylase and lipases in the drainage fluid in patients with intestinal fistulas with time courses.MethodsThe samples were collected from 16 patients with high intestinal fistulas from July 1998 to January 2008.The amounts of bacteria from the drainage fluid were measured 0,2 and 4 hours after taking out from the patients.At the respective time points,the intestinal juices were also collected to measure the amylase and lipase expressions.After reinfusion of succus entericus,thelevels of albumin,prealbumin,transferring,and fibronectin were measured at 0,7,and 14 days,ResultsThere was no significant increase of bacteria in the drainage fluid within 4 hours ( F(0,2) =18 812.50,P ＞ 0.05 ; F(0,4) =387 625.00,P ＞ 0.05).and there was no change in the expressions of amylase ( F(0,2) =190.60,P ＞ 0.05 ;F(0,4) =631.75,P＞0.05) and lipase within 4 hours (F(0,2) =204.10,P＞0.05; F(0,4) =1080.05,P＞0.05).After succus entericus reinfusion,the fibronectin (F(0,14) =74.24,P ＜ 0.01 ; F(7,14) =59.78,P ＜0.01),transferring (F(0,14) =0.46,P ＜ 0.01 ; F(7,14) =0.39,P ＜ 0.05 ),and prealbumin ( F(0,14) =54.37,P ＜ 0.05) were increased significantly.ConclusionsBacteria and enzymes do not increase in the drainage fluid within 4 hours in patients with intestinal fistulas.Therefore,it is safe and effective to reinfuse succus entericus.

Objective To detect COX-2 expressions in primary tumor and axillary lymph node tissues of breast cancer,and to study the relationship between COX-2 expression in breast cancer and lymph node metastasis.Methods The expressions of COX-2 in 9 normal breast tissues,50 primary breast cancer tissues,19 positive axillary lymph nodes and 31 negative axillary lymph nodes were detected with immunohistochemistry S-P method.Results COX-2 staining was granular and localized to the cytoplasm of tumor cells.In normal breast tissues,COX-2 staining was granular and localized to mesenchymocyte.In negative lymph nodes,COX-2 staining was granular and localized to macrophagus cytoplasm.The positive expression rates of COX-2 in normal breast tissues,primary breast cancer tissues,positive axillary lymph nodes and negative axillary lymph nodes were 11.1%,60.0%,84.2%,and 32.3%,respectively.There were significant differences of COX-2 positive expression rates between normal breast tissues,primary breast cancer tissues and positive axillary lymph nodes(P

Objective To investigate the effects of different clipping time of first time using permanent aneurysm clips on common carotid artery wall in rabbitsMethods Sixty healthy male Japanese white rabbits were selected.The first time permanent aneurysm clips were used to clip common carotid artery for 30 min or 60 min respectively according to the random number method (n=30 in each group).Thirty segments of common carotid artery specimens clipped by aneurysm clips were collected respectively.Mean-Whitney U test was used to conduct the comparison of histopathological damage grade of vascular wall.Results The aneurysm clips were use to clip 30 min and 60 min caused vascular wall injury could observe the middle elastic plastic plate deformation and endothelial denudation.The vascular walls in the clipping 60 min group had local necrosis with inflammatory response,and even rupture of vascular wall.There were significant differences in overall damage degree of vascular wall (U=324.00,P=0.045) and severe injury rate (0%[0/30] vs.20.0%[6/30],P=0.031) between the clipping 30 min group and the clipping 60 min group (all P<0.05).Conclusion The vascular wall injury of using disposable permanent aneurysm clips for clipping 60 min was more severe than 30 min.Attention should be paid to shortening the time of carotid artery occlusion in operation.

Objective To investigate the efficacy and safety of modified endoscopic submucosal dissection (ESD) and rubber band ligation assisted endoscopic dissection for treatment of small gastric submucosal tumors (SMT) originating from the muscularis propria layer. Methods A total of ninety-two patients diagnosed as gastric SMT (6 mm≤diameter≤13 mm) originating from the muscularis propria layer by EUS in our hospital were enrolled in this study. With intravenous anesthesia and tracheal intubation in all patients, modified ESD was performed firstly to stripe the small tumors. After being exposed to a certain extent, the tumors were ligated by rubber band and snared for endoscopic dissection. The situation of bleeding, perforation in both intraoperative and postoperative, the integrity and size of the resected specimens were observed and recorded. The resected specimens were identified with histopathological detection and immunohistochemistry assay. At the 6-month and 12-month after the operation, all patients were reviewed by gastroscopy and EUS in our hospital. Results All the 92 tumors were resected completely and successfully. The mean operating time was (19.2±2.3) min and the mean blood loss in operation was (2.6±0.5) mL. Perforation after resection occurred in 3 cases, which were closed with metal hemostatic clips and nylon ropes. No delayed bleeding and perforation occurred in one week after the operation. The tumor sizes ranged from 6 mm × 5 mm to 13 mm × 12 mm. Seventy-three gastric stromal tumors (risk classification:all were very low risk), 18 gastric leiomyomas and 1 gastric neurofibroma were identified. There were no residue or recurrence in all cases during the 12-month follow-up period. Conclusion The modified ESD and rubber band ligation assisted endoscopic dissection are effective and safe for treatment of small gastric submucosal tumors originating from the muscularis propria layer. The tumors are resected completely and successfully, showing certain significance to assess the nature, degree of malignancy of the tumor and prognosis of the patients.