Objective To improve diagnosis and treatment of bladder cancer. Method From January 1998 to October 2008, 23 cases of bladder cancer with clinical data were reviewed. Results Two patients were lost to follow-up, 21 patients were followed up from 5 months to 10 years,with one-year survival in 10 cases (47%), two-year survival in 7 patients (33%), five-year survival in 4 cases (19%) . All patients Survived more than 5 years were in with early stage. Conclusions Early diagnosis and suitable operation mode can help to improve the prognosis of patients.

OBJECTIVE: To prove that the neural stem cell can be separated from neural tissue in adult mammalian. Stem cells can separate and proliferate continually, and can divide further into neuron and glial cell. The uptodate researches of neural stem cells suggest a prospective approach to treat neurological diseases, i.e. the dysfunctional cells may be replaced with neural stem cells by transplantation for functional reconstruction. Therefore,many kinds of directional differentiative signal controlling of neural stem cells to differentiate at a certain direction.DATA SOURCES: Using the key term neural stem cell, differentiation,signal and cell transplantation, we searched the MEDLINE database plus the relevant articles in English language from January 1995 to August 2004. Meanwhile, using the key terms mentioned above, we searched Chinese journal full-text database, Wanfang database in Chinese language from January 1995 to August 2004.STUDY SELECTION: The articles on extracellular signal of the differentiation of neural stem cell with full summarization were selected.DATA EXTRACTION: A total of 30 articles were eligible, and the relevant contents were compared and summarized. Eighteen articles were selected at last.DATA SYNTHESIS: All 18 articles contained different aspects of signal regulation of neural stem cell, including various key cellular factors and autogene regulation.CONCLUSION: Both cellular signals in vivo and in vitro can affect the cell differentiation. The vital problem to be solved is how to induce neural stem cells to differentiate at a certain direction so as to realize the aim of transplantation.

There is no unity in judgment of obesity at home and abroad.WHO considered that there should have different evaluation criteria from childhood below and above 10 years and recommended "weight for height" be used for children under the age of 10 and body mass index(BMI)for children aged 10 to 24 years old.International Obesity Task Organization(IOTF) recommended BMI be suitable for young children for judgment overweight and obesity.Both of them had the same BMI standards for overweight and obesity for 18-year-old,25 and 30 kg/m2,respectively.But the Working Group on Obesity of China(WGOC)developed a criterion which cut-offs in 18 years were lower than that of WHO and IOTF,24 and 28 kg/m2,respectively.The treatment of obesity in childhood was different from that in adults.Many methods used for adults such as surgical liposuction,slimming drugs,hunger therapies and fasting could not be appropriate for childhood.A combined treatment in childhood including behavior modification,diet adjustment and exercise was recognized domestically and internationally.

Objective To explore the role of tissue-type plasminogen activator(tPA) in neonatal rat with hypoxia-ischemia brain damage(HIBD).Methods Seven-day-old Wistar rat pups were used for the Vannucci model of HIBD.Reverse transcription-polymerase chain reaction(RT-PCR),terminal deoxynucleotidyl transferase mediated dUTP nick end labeling(TUNEL),double immunostaining and immunoblot analysis were adapted to determin the expression of tPA at acute phase after HIBD and neural cell apoptosis and the blood-brain-barrier(BBB) damage.Results Neonatal hypoxia-ischemia triggers persistent induction of the plasminogen system.The increase of tPA activity induced the degradation of laminin and occludin which would aggravate the BBB damage.The number of neural cell apoptosis after HIBD increased progressively with the reperfusion time.Conclusions The increase of tPA at the acute phase after HIBD can help clot to dissolve,while its extravascular proteolysis will induce cell apoptosis and BBB damage which will aggravate brain injury.

Objective To investigate the joint ureteroscope U100 laser lithotripsy in treatment of children with u rinary stone.Methods Fifteen Cases of children established access ostomy through percutaneous renal puncture,5 cases of children established access ostomy via bladder puncture,3 patients conducted Lithotripsy under the direct observation.Results Twenty-three cases were with successful puncture and laser lithotripsy treatment.After re view of 19 cases no stone Was found,with a Success rate of 82.6%,4 cases with residual stones,of which 3 cases from the original ostomy and removed after second lithotripsy,and 1 case self-discharged,surgery averaged 45 mi nutes,hospitalization averaged 8 days.There waft no surgical complications.Conclusion The joint ureteroscope U100 laser lithotripsy treatment of children with urinary tract stones is fast,safe,effective,less traumatic,easy to operate,with ideal treatment outcomes.

Objective To summarize the clinical and pathological features and the diagnosis and treatment of ureteral aggressive angiomyxoma (AAM),to deepen understanding in the disease.Method s Diagnosis and treatment of 3 cases of ureteral AAM from January 1991 to January 2011.Results Three cases of ureteral AAM were female,post-operative pathological diagnosis was made,no recurrence occurred during follow up.Conclusions Ureteral AAM is rare,occur frequently in women,with clinical symptoms hidden,not typical.Diagnosis is based on histopathological and immunohistochemical examinations.Attention should be paid to differential diagnosis from soft tissue and other mucinous tumors.Surgery is not easy and complete,with disease easy to relapse after surgery.

Objective To study the clinical and pathological features and treatment method of adrenal cortical eosinophil tumor.Methods Retrospective analysis was made on the clinical data of 5 cases with adrenal cortical eosinophic tumor.Results Among the 5 cases,1 case looked female male-driven,1 case demonstrated cortisol dysrhythmias with cortisol increase combined Cushing syndrome,3 cases of no specific demonstrations,tumor sized 13 cm × 12 cm × 10 cm to 8.0 cm ×6.0 cm ×5.5 cm.Capsule was found complete,and no adhesion.Incision cut appeared gray,trypan-blue and cytoplasm contained rich acidophilus grain,the nuclei were large with a mild alien,fission were rare.Two cases were found immunohistochemical NSE ( + ),VIM ( + ).No relapse and metastasis were found after tumor resection.Conclusions Adrenal cortical eosinophil tumor is clinically rare,mostly being the occasional tumors.In general the tumor size is larger,more being benign tumor,growing quickly.Surgical resection is the first choice for the treatment of the disease,with good prognosis.Postoperative follow-up is needed.

OBJECTIVE To learn the effect of performance management to enhance the proper administration of antibiotics in hospital.METHODS The performance management was applied in the proper administration of antibiotics usage.It included perfected regulation system,established the standard of the performance management,enhanced monitoring,analyzed the popular trend of drug-resistant bacteria,educated the medical staff and guided their appropriate antibiotics usage.RESULTS After taking the performance management in the administration of antibiotics,the rate of the antibiotics usage decreased from 55.1% to 44.2% and the rate of hospital infection decreased from 5.26% to 4.69%.The drug-resistant bacteria ratio obviously repressed.CONCLUSIONS Application of the performance management(a modern science management measure) in the proper administration of antibiotics usage is effective.

Objective To observe and discusses the application of larger-bore autologous arteriovenous fistula as dialysis pathways in diabetes patients with chronic renal failure. Methods 86 cases of diabetic patients with chronic renal failure were divided into elderly group and non-elderly group. The patients within each group were assigned randomly into Experimental subgroup and control subgroup. Patients underwent wrist autogenous arteriovenous fistula angioplasty.The surgical method was end to side anastomosis between cephalic vein and radial artery. Vertical incision on the radial artery is about 0.7 cm-0.8 cm in the control subgroup and vertical incision on the radial artery is about 1.0 cm-1.1cm in the experimental subgroup. Results The success rate of the operation in experimental subgroup(90.9%, 95.2%) was significantly higher than that of control group(77.3%, 85.7%). The differences were significant (P<0.05). There was no heart failure in the patients underwent surgery. Conclusions In diabetes patients with chronic renal failure need autogenous arteriovenous fistula angioplasty. Properly increasing the diameter of anastomosis can meet the demand on blood flow of hemodialysis without increase complication of heart failure.

Vascular surgery is a new and course crossing medical science and has developed rapidly in recent years.The patients of vascular surgery have become more and more and are usually diagnosed incorrectly,so we should put emphasis on vascular surgery teaching and take advantage of multimedia,real demonstration and so on.