Objective: To investigate the role of prostate specific antigen(PSA) in screening for prostate cancer. Methods: The serum PSA of 4 848 males over 50-years old for serum PSA was evaluated,respectively out of them 33 cases diagnosed as prostate cancer(screening group) were compared in terms of age distribution,level of PSA,clinical stages,Gleason score and treatment modalities with 28 patients in our hospital(clinical group). Results: In the screening group,the positive percentage account for 9.5%(PSA≥4 ng/ml) and the PCa positive rate was 6.8‰(33/4 848).The average age of the patients(73.2?8.0) was insignificant different between these two groups.The percentage of the cases beyond 20 ng/ml PSA in the screening group was significantly lower than that in clinical group,with 42.4% and 71.5% respectively.Furthermore,the cases with clinical stage A+B accounted for 69.7% in the screening group,while it was 35.7% in the clinical group(P

Objective To study the diagnosis accuracy and the treatment sequelae of adenocarcinoma of urinary bladder. Methods 41 cases of urinary bladder adenocarcinoma have been encountered from 1980 to 2000,all of them had undergone operation and the diagnosis being assessed on histopathology studies.There are 18 cases of primary bladder adenocarcinoma,among which 8 had undergone radical cystectomy and 10 partial cystectomy.Among 12 cases of urachal adenocarcinoma extending to the bladder,11 received extended resection.All the 11 patitents with metastatic focus in the bladder underwent local ablation. Results Urinary bladder adenocarcinoma comprised 3.2% of the bladder cancer.Thirty seven patients have been followed up for five months to ten years.The 1 year survival rate was 51.3%(19 cases),the 2 year survival rate 43.2%(16 cases) and the 5 year survival rate 21.6%(8 cases). Conclusions Radical total cystectomy is the treatment of choice for primary adenocarcinoma of bladder and extended partial cystectomy seems to be the best for urachal adenocarcinoma. Comprehension therapy should be undertaken for patients with metastatic adenocarcinoma or tumor recurrence so as to improve the survival rate.

Objective To evaluate the modified Stamey bladder neck suspension for female stress urinary incontinence. Methods 52 cases with an average age of 46 and an average stress incontinence history of 7.5 years underwent the modified Stamey procedure,18 cases being degree Ⅰ,21 degree Ⅱ and the other 13 degree Ⅲ. Results 32 cases were treated before 1994 and the outcome was evaluate at 3.6 years and 9.6 years postoperatively.There were 3 failures because of operative complication.The cure rates and failure rates at 3.6 and 9.6 years were 87.5%,68.8% and 6.2%, 21.9%,respectively.20 cases were treated after 1994 with a follow up of 4.3 years.The cure rate has been 90.0%. Conclusions The Stamey procedure yields high initial cure rates yet the latter declines with time.

Objective To investigate the effects of combination of retinoids and interferon ?-2a on growth inhibition and apoptosis induction in bladder cancer cell lines. Methods Four bladder cancer cell lines and two retinoids,all-trans-retinoic acid (ATRA),9-cis retinoic acid (9cRA),combined with interferon ?-2a(IFN),were used in the study.The abilities of these agents to inhibit growth,induce apoptosis were compared and the expression of nuclear retinoid receptors,Stat1 protein were measured by means of TUNEL,FCM,RT-PCR and Western blot. Results Most of the bladder cancer cell lines were resistant to the effect of ATRA and 9cRA on growth inhibition and apoptosis induction.The effects of ATRA and 9cRA on cell growth and apoptosis were enhanced by IFN ?-2a.Combination of ATRA and IFN ?-2a induced RAR? and Stat 1 expression in three bladder cancer cell lines. Conclusions INF ?-2a synergizes with the inhibitory effect of ATRA and 9cRA on the growth inhibition and apoptosis of bladder cancer cells in vitro,up-regutation of Stat1 gene expression could be the main molecular mechanism.

OBJECTIVE:To observe the efficacy and safety of Bifid triple viable capsule in the treatment of ulcerative colitis (UC). METHODS:94 patients with UC were randomly divided into control group and research group. Control groups was given nutrition support,light diet and 5-amino salicylic acid and other conventional treatment;research group was additionally given 420 mg Bifid triple viable capsule,3 times aday. Treatment course for both group was 8 weeks. The clinical efficacy,and serum D-lac-tic acid,diamine oxidase(DAO)levels before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in research group was significantly higher than control group,the difference was statistically sig-nificant(P<0.05);after treatment,serum D-lactic acid,DAO levels in 2 groups were significantly lower than before,and re-search group was lower than control group,the differences were statistically significant(P<0.05 or P<0.01);and there was no sig-nificant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Based on the conventional treatment,both the efficacy and safety of Bifid triple viable capsule are good in the treatment of UC.

Objective To highlight the diagnostic and t herapeutic procedures for extra-adrenal pheochromocytoma. Methods Thirty-eight cases of extra-adrenal pheochromocytoma proven patholo gically from 1998 to 2002 were reviewed and studied.Hypertension was observed in 34 cases and intermittent macrohematuria in 4 patients.Another 2 cases were adm itted to hospital with abdomen masses through routinely physical examination.Uri nary VMA,serum and urinary catecholamine were measured in 33 cases.38 cases had B-model ultrasound examination and 34 cases took CT scan.The level of urine VMA elevated in 30 cases(91%) and serum or urinary catecholamine were elevated in 2 8 (85%).The positive rates of localization of B-ultrasound and CT were 92% and 100%,respectively.29 cases took ?-receptor blocker for at least 2 weeks preope ratively.There were 6 cases operated under epidural anesthesia and 32 general an esthesia.Six cases were operated transvesical.10 cases with lumber incision and 19 with abdominal incision.The other 3 cases operated laparoscopically. Results Tumor location,6 cases in bladder wall,7 in renal hilum, 9 in upper pole of kidney,4 in low pole,10 in anterio-lateral to the adrenal gl and,and 2 cases of multifoci.The specimens were from 2 to 9 cm in size.Among 34 cases with hypertension,the blood pressure of 26 patients return to normal and 2 cases were still hypertensive.10 cases were assayed as malignant pheochromocyto ma.There were 9 cases of recurrence or metastases and 5 patients died during fol lowed-up from 13 months to 10 years. Conclusions Urine VMA level is a useful marker to detect extra-adrenal pheochromocytoma and CT sc an is the most reliable in localizing the lesions. 131I-MIBG scintigra phy is of great value for the localization and quantitative for extra-renal phe ochromocytoma with high sensitivity and accuracy.It may be also used as a therap eutic method.Surgical manipulation of the tumor is the best management and metic ulous perioperative management is extremely important.Measuring the level of uri nary catecholamine can monitor the recurrence or metastasis of the tumor.

We report the results of nephrectomy under laparoscopy for 3 patients. Three patients were subjected to laparoscopy for the treatment of hydronephrosis of no function under general aneshesia. Succesiful operation was performed in the 3 patients without complication, the average operation time being 240 minutes, and hospitelization duration averaging 4.5 days.

Objective To explore the effectiveness of tension-free vaginal tape (TVT) for female stress urinary incontinence. Methods Thirteen cases of stress urinary incontinence confirmed by urodynamics examinations underwent treatment with tension-free vaginal tape through the anterior vaginal wall under an epidural anesthesia. The patients were positioned in the lithotomy position. Dissection was performed alongside the urethra bilaterally by way of the anterior vaginal wall. A TVT suprapubic tape was passed through the lower abdominal wall and was positioned and adjusted. Results The operation time was 15~45 min (mean, 35 min). Follow-up observations for 6~24 months (mean, 13 months) in 13 cases revealed 12 cases of cure and 1 case of improvement. No recurrent urinary incontinence or dysuria was noted. Conclusions Treatment with TVT is a simple, effective and minimally invasive procedure for stress urinary incontinence, with a short operative time and a quick postoperative recovery.

Objective To comprehend the clinical characteristics and treatment of primary hepatic amyloidosis.Methods A total of 10 cases of primary hepatic amyloidosis included. 4 cases from Peking Union Medical College Hospital and 6 cases from other hospitals.reported in the literature in recent 20 years were reviewed,Results (1)The frequent clinical symptoms related to primary hepatic amyloidosis presented as hepatomegaly(90%),abdominal distension(80%),shifting dullness(60%),anorexia(50%),fatigue(40%),edema(40%),weight loss(40%) and abdominal pain(30%).(2)Laboratory tests revealed elevated serum alkaline phosphatase which was (558.3?517.2)U/L,and other liver function involvement were rare:six patients(85.7%)had either a serum or urine monoclonal protein.(3)Liver biopsy is golden standard.The amyloid deposition was mainly located at sinusoida(4 casese,57.1%),and only 2 cases was at vascular(28.6%).Complication of bleeding after liver biopsy was reported(1 case).(4)The classical therapy scheme was melphalan and prednisone,four cases died from liver function failure and infection.Conclusion The clues to the diagnosis of primary hepatic amyloidosis include elevated monoclonal protein,hepatomegaly and an unexplained elevated serum alkaline phosphatase level which is not parallel with other liver functions.Live biopsy is golden standard.The treatment scheme include melphalan and prednisone,but its prognosis is poor.

BACKGROUND: Electromagnetic pulse (EMP) radiation can affect the learning and memory function of experimental rats and induce injury of hippocampal issues and change of ultrastructure of rats.OBJECTIVE: To observe the effects of EMP on injury of hippocampal neurons cultured in vitro and [Ca2+]i, and analyze deeply possible mechanism of cerebral injury induced by EMP.DESIGN: Randomized controlled animal experiment.SETTING: Department of Pathology, Chengde Medical College.MATERIALS: Several Wistar neonate rats, of either sex (half and half),were selected. Source of EMP radiation was high intensity EMP dummy source.METHODS: The experiment was performed from March to December 2004 at the Academy of Military Medical Science and Chengde Medical College, respectively. Several Wistar neonate rats were decapitated to take out the brains under narcotization. Hippocampal tissues were isolated. The cell suspension was adjusted to 5×108 L-1 for inoculation. Grouping: ①Cultured cells were assigned into control group and radiation group. Cells were collected immediately after radiation to perform observation of morphology and determination of free calcium ion concentration. ②Other cultured cells were divided into control group, 0-hour radiation group and 12-hour radiation group. Cell apoptosis rate and necrosis rate were determined. (Dosage of cultured cells: one culture flask of each group was checked in each item for 3 times). EMP radiation was in 6×104 V/m, with pulse rise time of 20 ns,pulse width of 30 μs, frequency of 2.5 pulses/min, totally for 2 minutes.EMP radiation was performed in primary cultured hippocampal neurons,and then morphological change of neurons was observed under inverted phase contrast microscope before and after radiation. Cell apoptosis and necrosis were measured with FACS method; Free [Ca2+]i concentration in neurons was measured with Fluo-3-AM fluorescent probe loading and laser confocal microscopy scanning.MAIN OUTCOME MEASURES: Morphological change of neuron, cell apoptosis rate and necrosis rate and free [Ca2+]i concentration.RESULTS: ①Immediately after EMP radiation, the onset of colliquation appeared in nerval cells gradually, and neurite was recovery and degeneration. ②Apoptosis rate after 12-hour EMP radiation recovered as compared with that at hour 0 after radiation, but significantly increased as compared with the control group [(59.27±1.27)%, (72.17±6.21)%, (17.45±5.63)%,P＜0.05]. ③Necrosis rate at hour 0 and hour 12 after radiation increased as compared with the control group, but there was no statistical significant difference [(13.71±2.31)%, ( 11.96±1.04)%, (8.45±0.67)% ,P ＞ 0.05].④[Ca2+]i fluorescence intensity at hour 0 after EMP radiation was higher obviously than that in the control group (107.34±26.14,54.93±16.08,P ＜ 0.05).CONCLUSION: EMP induces morphological injury, necrosis and increase of apoptosis rate in hippocampal neurons, and Ca2+ fluorescence intensity increases markedly in neurons.