Anastomosis, Surgical ; methods ; Humans ; Organ Transplantation ; adverse effects ; methods ; Postoperative Complications ; etiology ; surgery ; Vascular Surgical Procedures ; methods

Objective To investigate the diagnostic and therapeutic characteristics of prostate cancer with prostate specific antigen(PSA)4-10?g/L. Methods The data of prostate biopsies for the patients with PSA 4-10?g/L from May 1998 to February 2004 and the treatment and prognosis of these patients were retrospectively analyzed. Results In the 141 cases, 34 were diagnosed as prostate cancer, including 3 cT1, 21 cT2, 6 cT3 and 4 cT4. Mean Gleason score was 5.8, and the mean Gleason scores of cT1 and cT2 were significantly lower than those of cT3 and cT4. Twenty-four cases of cT1 and cT2 underwent radical prostatectomy. Four cases of cT3 recieved radical prostateetomy after 4 months of neoadjuvant endocrine therapy. Two cases of cT3 and 4 cT4 received castration. Pathological section from radical surgeries showed that 21 cases were organ confined and 7 were locally invasive. The difference of mean Gleason score between these two groups was significant in statistics. After 18 to 69 months (mean 42 months)follow-up, 21 organ confined cases were free survived, 4 locally invasive cases had biochemical recurrence and 1 case had multifocal bone metastasis. No cancer-specific death happened. Two of 4 cT4 cases were still alive and 2 died of the tumor. Conclusions Routine needle biopsy is necessary for the cases with“grave area”PSA of 4～10 ?g/L. Prostate cancers with PSA 4～10/?g/L are not always early diseases. Gleason score is a very important index for determine the stage of pathology after surgery. Radical prostatectomy is an effective treatment for organ confined disease.

Capsid Proteins ; genetics ; metabolism ; Simplexvirus ; genetics ; metabolism

Objective To analyze the clinical characteristics of children massive cerebral infarction after traumatic brain injury. Methods The clinical data of 33 children with massive cerebral infarction after traumatic brain injury were retrospectively analyzed. Results Among the 33 children, 24 cases suffered from falling, 10 cases were involved in traffic accidents, 1 case suffered from violence and 1 case was hit by falling object. The massive cerebral infarction occurred in all objects: 9 cases in 1 day after head trauma, 14 cases in 1 - 3 days, 7 cases in 4 - 7 days, and 3 cases after 7 days. Eighteen patients were performed operation to evacuate the intracranial hematoma and decompression. Antiplatelet agents, calcium antagonist and low molecular dextran were administered in all patients after exclusion of bleeding tendency. The follow-up period of all children ranged from 6 months to 24 months. According to Glasgow outcome score (GOS):18 cases showed a good outcome, 6 cases were moderately disabled, 1 case was severely disabled, 1 case survived in a permanent vegetative state and 7 cases died. Conclusions The main causes of children massive cerebral infarction with traumatic brain injury are falling and traffic accident. With proactive treatment, the prognosis of children survivors is acceptable.

OBJECTIVETo explore the effect of total flavonoids of Herba Epimedium (FHE) on BMP-2/RunX2/OSX signaling pathway in promoting osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs).

METHODSPassage 3 BMSCs were randomly divided into the control group, the experimental group, and the inhibitor group. BMSCs in the control group were cultured in 0.2% dimethyl sulfoxide + Osteogenuxic Supplement (OS) fluid + DMEM/F12 culture media. BMSCs in the experimental group were intervened by 20 microg/mL FHE. BMSCs in the inhibitor group were intervened by 20 microg/mL FHE and 1 microg/mL NOGGIN recombinant protein. At day 9 alkaline phosphatase (ALP) activity was measured. Calcium nodules were stained by alizarin red staining and the density was observed. The transcription expression of osteogenic differentiation-related proteins (type I collagen, osteocalcin, and osteopontin) and related factors of BMP-2/RunX2/OSX signaling pathway was assayed by RT-PCR.

RESULTSCompared with the control group, ALP activities were enhanced and the density of calcium nodules significantly increased; type I collagen, osteocalcin, and osteopontin expression levels were increased in the experimental group. The expression of osteogenesis-related transcription factor was also increased in the experimental group. Noggin recombinant protein inhibited FHE promoting BMSCs osteogenesis in the inhibitor group. Compared with the experimental group, ALP activity decreased (P < 0.05), the density of calcium nodules was lowered, expression levels of type I collagen, osteocalcin, osteopontin significantly decreased (P < 0.05) in the inhibitor group.

CONCLUSION20 microg/mL FHE promoted osteogenic differentiation process of BMSCs by BMP-2/RunX2/OSX signaling pathway.

Bone Morphogenetic Protein 2 ; metabolism ; Cell Differentiation ; drug effects ; Cells, Cultured ; Collagen Type I ; metabolism ; Core Binding Factor Alpha 1 Subunit ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Epimedium ; chemistry ; Flavonoids ; pharmacology ; Humans ; Mesenchymal Stromal Cells ; cytology ; drug effects ; Osteocalcin ; metabolism ; Osteogenesis ; drug effects ; Osteopontin ; metabolism ; Signal Transduction ; Sp7 Transcription Factor ; Transcription Factors ; metabolism

A total of 1 100 patients underwent renal transplantation in the Organ Transplantation Center,Second Affiliated Department of General Hospital of Chinese PLA between 1988 and 2008 were collected,and retrospective analysis was performed in five female patients with malignant tumor,which appeared at 68 months (20-132 months) following renal transplantation,including 2 with renipelvic and uretal cancer and 3 with bladder cancer. Two of the 3 patients with bladder cancer presented homolateral renipelvic and uretal metastasis. Three cases and 1 case of upper uretal cacer were observed at the homolateral or heterolateral of kidney grafts respectively. The main characteristic of sign was iterative and painless gross hematuria. The 5 patients underwent renal transplantation with intravesical instillation therapy and nephrectomy. All patients were survived without rejection in the 1-62 months follow-up. The incidence of malignancy in renal allograft recipients is much higher than that in normal ones,which is related to the long term use of immunosuppressants. Urinary epithelial cancer is the main complicating carcinoma and the first choice of treatment is surgical operation. Based on the normal renal grafts function,the dose of immunosuppressants should be as low as possible,Moreover,radiotherapy or chemiotherapy should be adopted according to the types and stages of tumor complicating renal transplantation.

·AIM: To analyze the clinical manifestation of Alport syndrome, especially the ocular features.·METHODS: The physical, ophthalmologic and audiologic examination results of thirty two patients with Alport syndrome were analyzed retrospectively.·RESULTS: Thirty (93.7%) patients had some family history. All patients had renal disease: eighteen(56.3%) patients with chronic renal failure, four(12.5%) patients with renal insufficiency, and the other ten(31.3%) patients with hematuria. Twenty (62.5%) patients had sensorineural deafness. Thirteen (40.6%) patients had ocular deformity, five(15.6%) patients had typical ocular changes: three patients with anterior lenticonus, and two patients with macular flecks.·CONCLUSION: Ocular anomalies are not requisite for the diagnosis of Alport syndrome. But its typical ocular features should be recognized by the ophthalmologists which supports the diagnosis.

Objective: To study the factors and preventive method of post-operative complications of spinal implant operation. Methods: The post-operative complication of 451 cases who had undergone spinal implant operation were analysed retrospectively. The relative factors of complications were analyzed. Results: Infection, thrombosis of deep vein and failed fusion were the most common complications. Among the factors, the age, operation time and blood lose during operation were closely related with the complication. Using antibiotic was effective to reduce the infection. Conclusion: It is effective to reduce the post-operative complication of spinal implant operation by proper pre-operative evaluation. Using antibiotic to control other diseases is also effective.

Objective To analyze the safety and effectiveness of photoselective green-light laser vaporization of the prostate(PVP)in treatment of large prostate with volume more than 80 ml. Methods Retrospective analysis was performed in 25 benign prostatic hypertrophy patients undergoing the PVP treatment,whose prostate volume was more than 80 ml.Results Twenty-five patients with prostate mean volume of 151.8(84.0-270.0)ml were treated by PVP and 23 cases were finished successfully.One operation was suspended because of bleeding and the other because of damaging orifice.No blood transfusion was needed and no“transurethral resection(TUR)syndrome”happened.Five cases had acute retention and 2 of them needed second PVP.In a mean of 7.9(3.0- 12.0)months follow-up,maximal urinary flow rate(Qmax),international prostate symptom score (IPSS),quality of life score(QOL),and prostate-specific antigen(PSA)level were improved significantly.The volume of prostate reduced after PVP than before PVP but no significant difference was found.Conclusions PVP is feasible in treating large prostate even the volume is more than 80 ml,although it needs better skill.Catheterization for some time is helpful in reducing the incidence of early postoperative acute urinary retention.

Objective To investigate the effects of T. gondii soluble tachyzoite antigen (STAgs) on the survival time of mouse heart allograft and the possible mechanism. Methods The STAgs were prepared by pulverizing T. gondii tachyzoite with ultrasound on ice. Cervical heterotopic heart transplantations were done by using Balb/c mice as donors, and C57BL/6 mice as recipients.The recipients were classified randomly into three groups: syngeneic group, acute rejection group and STAgs-treated group. The recipients in acute rejection group and STAgs-treated group were injected subcutaneously with 0. 1 ml PBS and 0. 1 ml (5 μg) STAgs at the 4th day before transplantation respectively, and those in syngeneic group were not subjected to any treatment. The grafts were observed daily by cervical palpation, and the total cessation of cardiac contraction was defined as the endpoint. The heart allografts were harvested at the 7th day after transplantation for pathological examination and immunohistochemical staining for CD4+ T, CD8+ T. Results The recipients in syngeneic group were all alive at the 100th day after transplantation. The average survival time in acute rejection group and STAgs-treated group was (6.7± 0.5) days and (70.8± 3.5) days,respectively (P＜0.05). HE staining showed that the rejection on the 7th day after transplantation in syngeneic group, acute rejection group and STAgs-treated group was fallen into 0 degree, Ⅲ-Ⅳ degree and 0- Ⅰ degree, respectively. Immunohistochemical staining revealed that the CD4+ T and CD8+T were markedly down-regulated in STAgs-treated group as compared with those in acute rejection group. Conclusion T. gondii STAgs can significantly prolong the survival time of mouse heart allograft and inhibit the rejection probably by changing the ratio of TH1/TH2, or inhibiting the effect of dendritic cells by inducing the lipoxin A4.