Objective To investigate the treatment effect of daily low dose of sildenafil treating interstitial cystitis .Methods 68 patients with interstitial cystitis in our hospital from June , 2012 to December, 2013 were divided into observation group and con-trol group by digital randomized method, 34 cases in each group.Observation group adopted daily dose of sildenafil 0.25 g treatment every day, and control group adopted the same dose of starch placebo every day.Two groups were treated for 3 months.Curative effect, micturition number a day before and after the treatment, the maximum bladder capacity, interstitial bladder inflammation shape index and problem index score ( ICSI, ICPI) , pelvic pain and urinary frequency score ( PUF) and quality of life scores ( QOL) of two groups were compared.Results The rate of significant curative effect and total effective rate of observation group were significantly higher than that of the control group, and the difference was statistically significant (p<0.01).Micturition number every day, the maximum bladder capacity, ICSI, ICPI, PUF and QOL scores of the two groups before treatment had no statistical significant differ-ences(p>0.05).Maximum bladder capacity and QOL scores of observation group after treatment were (265.44 ±43.85) ml and (44.15 ±4.69) respectively, which were higher than the (92.45 ±25.71) ml and (22.14 ±2.97) of the control group after treat-ment and (94.12 ±23.95)ml and (22.38 ±3.18) of observation group before treatment;Urine per day, ICSI, ICPI and PUF of ob-servation group after treatment is lower than that of the observation groups after treatment and that of the control group before treat-ment, and the difference had statistically significant (p<0.05).Conclusion Daily low dose of sildenafil for treating women with in-terstitial cystitis is worthy of clinical use for it can effectively relieve clinical symptoms and improve patient's life quality.

Objective To analyze the characteristics of military training injury caused by distal femoral fractures that used reverse interlocking intramedullary nail(retrograte nails) and condylar plate to fix,and then compare the clinical treatment effects.Methods Retrospective analysis of clinical information of 30 cases,14 cases were treated with reverse interlocking intramedullary nail(reverse nail group) and 16 cases with condyle plate fixation(condyle plate group),all the cases were followed up for 12～20 months to compare the treatment effect and complications.Results According to Merchan criteria with clinical evaluation of knee function,the rate of good and excellent was 85.7% in the reverse interlocking in-tramedullary nail group,68.7%(P

Objective:To investigate the values of genetic polymorphisms of excision repair cross-complementation group 1 (ERCC1), thymidylate synthase (TS), glutathione-S-transferase P1 (GSTP1) and methylenetetrahydrofolate reductase (MTHFR) in predicting the prognosis of advanced esophageal cancer patients treated with cisplatin/fluorouracil chemotherapy.Methods:One hundred and seven patients with advanced esophageal cancer were enrolled in this study, 98 of which were eligible for analysis. All patients received cisplatin/fluorouracil chemotherapy repeated every three cycles. Genetic polymorphisms examined herein included those in the genes coding ERCC1, TS, GSTP1 and MTHFR. Then the relationships between genetic polymorphisms and response rate (RR) and progression free survival (PFS) time were analyzed. Results:The patients with A/A or A/C genotype in ERCC1-C8092A had a higher response rate and longer PFS than the patients with C/C genotype (P=0.010,P=0.008);the patients with 2R2R or 2R3C or 3C3C genotype in TS-5'UTR had a higher response rate and longer PFS than the patients with 2R3G or 3C3G or 3G3G (P=0.007,P=0.018). There was no significant relationship between RR and PFS and other genetic polymorphisms. Conclusion:The advanced esophageal cancer patients with A/A or A/C genotype in ERCC1-C8092A and/or 2R2R or 2R3C or 3C3C genotype in TS-5'UTR were more sensitive to cisplatin/fluorouracil chemotherapy.

Objective To investigate the partial safety of the recombinant adenovirus containing the triple-point mutants HIF-1αgene (Ad-HIF-1α-Trip)transfection in a rabbit model of hind limb ischemia. Methods After ligation of left femoral artery, 22 New Zealand whites rabbits were randomly divided into 3 groups: saline group(n=6), Ad-Null group(n=6) and Ad-HIF-1α-Trip group(n=10). After operation, saline, Ad-Null and Ad-HIF-1αwere injected intramuscularly respectively. The expression of transferred HIF-1αat mRNA level in the ischemic skeletal muscle and other important organs were detected by Real-time PCR 10 days after gene transfection. The body temperature, weight, blood, liver and renal function, as well as the myocardial enzymes were detected before operation, and on the 3th, 7th, 14th and 28th day after gene transfection, so that pathological changes could be observed. Results On the 10th day after gene transfection, obvious expressions of HIF-1αat mRNA level in the ischemic limb were found, but no expression in other important organs was detected in Ad-HIF-1α-Trip group. The blood routine, liver and renal function were all in the normal range (P > 0.05). No abnormalities were found in heart, liver, kidney, and lung HE transfection in Ad-HIF-1α-Trip group. Conclusion Single intramuscular injection of Ad-HIF-1α-Trip can be expressed obviously in the ischemic limb without detected damage of liver , cardiac and kidney.

Objective To investigate the clinical application and manifestation of dynamic contrastenhanced MRI (DCE-MRI) in differentiating true progession from pseudoprogression in patients with gliobastomas.Methods Twenty five glioma patients were treated with postoperative concurrent chemoradiotherapy and enrolled in this study.All patients were underwent DCE-MRI using a 1.5T scanner.Fifteen patients were confimmed by secondary pathology or clinical and imaging follow-up of patients with gliomas true progession (TP),10 patients were pseudoprogress (PP).Nonparametric Mann-Whitney test was used to compare perfusion parameters between two groups (TP and PP),were used for receiver operating characteristic (ROC) curve analysis to clear if these parameters can be the indicators to differentiate true progession from pseudoprogression.Results Ktrans (volume transfer constant),Ve (fractional volume of extravascular extracellular) values between TP and PP glioma groups were statistically significant,K and Ve values were significantly higher in the TP group than in the PP group (P ＜ 0.05).The areas under the ROC curve are 0.990 and 0.847,respectively.Kep (efflux rate constant) value,Vp (fractional volume of plasma) value in the identification of glioma TP group and PP group was not statistically significant (P ＞ 0.05).Conclusions DCE-MRI can be used to identify glioma TP and PP,Ktrans value and Ve value have clinical significance.

OBJECTIVETo evaluate the relationship between CT findings and immunohistochemical types of gastrointestinal stromal tumors (GIST).

METHODSCT imaging and clinicopathological data of 85 patients with GIST were analyzed retrospectively. The CT findings of GIST including lesion location, size, contour, boundary, tumor growth pattern, degree of enhancement, necrosis and calcification, were summarized and compared with the immunohistochemical types of the GIST.

RESULTSOf the 85 patients, smooth muscle differentiation was in 26 cases (30.6%), neural differentiation in 20 (23.5%) , both smooth muscle and neural differentiation in 10 (11.8%) and no obvious differentiation in 29 (34.1%) cases. GISTs occurred in the duodenum were more frequently seen in muscle type than in any other types, GIST with smooth muscle differentiation had higher prevalence of huge mass (larger than 10 cm), distinctive enhancement and extensive necrosis than other types (P < 0.05). There was no significant difference in the relationships of immunohistochemical types with tumor contour, boundary, growth pattern and calcification among the four groups of GIST (P > 0.05).

CONCLUSIONSCT scan is the most important and effective method for diagnosis of GIST. Analyzing CT signs has some potential value in judgmet of immunohistochemical types of GIST.

Diagnosis, Differential ; Gastrointestinal Stromal Tumors ; diagnosis ; metabolism ; Humans ; Immunohistochemistry ; Retrospective Studies ; Tomography, X-Ray Computed

Objective To evaluate the clinical value of holographic image navigation in urological laparoscopic and robotic surgery.Methods The data of patients were reviewed retrospectively for whom accepted holographic image navigation laparoscopic and robotic surgery from Jan.2019 to Dec.2019 in Beijing United Family Hospital and other 18 medical centers,including 78 cases of renal tumor,2 cases of bladder cancer,2 cases of adrenal gland tumor,1 cases of renal cyst,1 case of prostate cancer,1 case of sweat gland carcinoma with lymph node metastasis,1 case of pelvic metastasis after radical cystectomy.All the patients underwent operations.In the laparoscopic surgery group,there were 27 cases of partial nephrectomy,1 case of radical prostatectomy,2 cases of radical cystectomy and 2 cases of adrenalectomy.In the da Vinci robotic surgery group of 54 cases,there were 51 cases of partial nephrectomy,1 case of retroperitoneal lymph node dissection,1 case of retroperitoneal bilateral renal cyst deroofing and 1 case of resection of pelvic metastasis.There were 41 partial nephrectomy patients with available clinical data for statistic,with a median age of 53.5 years (range 24-76),including 26 males and 15 females.The median R.E.N.A.L score was 7.8 (range 4-11).Before the operation,the engineers established the holographic image based on the contrast CT images and reports.The surgeon applied the holographic image for preoperative planning.During the operation,the navigation was achieved by real time fusing holographic images with the laparoscopic surgery images in the screen.Results All the procedures had been complete uneventfully.The holographic images helped surgeon in understanding the visual three-dimension structure and relation of vessels supplying tumor or resection tissue,lymph nodes and nerves.By manipulating the holographic images extracorporeally,the fused image guide surgeons about location vessel,lymph node and other important structure and then facilitate the delicate dissection.For the 41 cases with available clinical data including 23 cases of robotic-assisted partial nephrectomy and 18 cases of laparoscopic nephrectomy,the median operation time was 140 (range 50-225) min,the median warm ischemia time was 23 (range 14-60) min,the median blood loss was 80(range 5-1 200) ml.In the robotic surgery group,the median operation time was 140 (range 50-215)min,the median warm i schemia time was 21 (range 17-40)min,the median blood loss was 150(range 30-1 200)ml.In the laparoscopic surgery group,the median operation time was 160(range 80-225)min,the median warm ischemia time was 25 (range 14-60)min,the median blood loss was 50 (range 5-1 200) ml.All the patients had no adjacent organ injury during operation.There were 2 cases with Clavien Ⅱ complications.One required transfusion and the other one suffered hematoma post-operation.However,the tumors were located in the renal hilus for these 2 cases and the R.E.N.A.L scores were both 11.Conclusions Holographic image navigation can help location and recognize important anatomic structures during the surgical procedures..This technique will reduce the tissue injury,decrease the complications and improve the success rate of surgery.