Objective To investigate the clinical and pathological features of prostate cancer with low level of serum prostate-specific antigen (PSA) in elderly patients.Methods Data of 328 patients with prostate cancer were retrospectively analyzed.Clinical and pathological data of 4 prostate cancer patients with low serum PSA level were analyzed.Potential risk factors and diagnostic methods of prostate cancer with low serum PSA level were discussed based on the clinical data combined with literatures.Results Mean age of the 4 patients was 71.3 years.Mean PSA value on admission was 1.96 μg/L.2 patients had abnormal digital anal examination results.2 patients were pathologically diagnosed as adenocarcinoma after puncture,among which 1 had duct adenocarcinoma,and the other 2 patients were pathologically diagnosed as neuroendocrine carcinoma after puncture.2 patients with neuroendocrine carcinoma of prostate were treated with endocrine therapy,and the other 2 patients were treated with radical prostatectomy plus auxiliary endocrine therapy.Conclusions Prostate cancer with low serum PSA level has an insidious onset,which is prone to miss the diagnosis.It should be paid sufficient attention for the diagnosis,and monitoring of prostate cancer is independent on PSA.Prostate cancer with low serum PSA level should be diagnosed in combination with some basic examinations such as serum free prostate specific antigen,prostate specific antigen density and digital rectal examination,et al.

OBJECTIVE: To discuss the pressure changing characteristics of upper esophageal sphincter (UES), lower esophageal sphincter (LES) and the esophagus kinetic characteristics of pharyngeal paraesthesia patients. METHOD: To take high resolution manometry in 44 cases of pharyngeal paraesthesia patients and 23 normal subjects separately. According to the RSI score,the 44 patients were divided into group A (the group without reflux, RSI < 13, n = 25) and group B (the group with reflux, RSI ≥ 13, n = 19). RESULT: The UES average resting pressure and average residual pressure of patients group were higher than the control group (P < 0.05); The UES average resting pressure and average residual pressure of group B were higher than group A (P < 0.05); The LES average resting pressure and average residual pressure of group B were lower than group A and the control group (P < 0.05); The comparison of LES average resting pressure and average residual pressure between group A and the control group was not statistically significant (P > 0.05). The esophagus DCI of group B was lower than that of group A and control group (P < 0.05). The esophagus DCI comparison between group A and control group was not statistically significant (P > 0.05). CONCLUSION The pharyngeal paresthesia symptoms of'patients was associated with the increasing of UES pressure. The pharyngeal paresthesia symptoms of group with reflux was related to low pressure of LES and high pressure of UES. The last part of esophagus of group with reflux had obstacles in powers, which weaken the peristalsis and declined the ability to clear the bolus and gastric reflux material.
Case-Control Studies ; Esophageal Sphincter, Lower ; physiopathology ; Esophageal Sphincter, Upper ; physiopathology ; Gastroesophageal Reflux ; physiopathology ; Humans ; Manometry ; Paresthesia ; diagnosis ; pathology ; Peristalsis ; Pharynx ; physiopathology ; Pressure

BACKGROUND:In recent years,bone defect caused by tumor,trauma,infection and so on is always the troublesome problem in the orthopaedics field. Many kinds of bone graft substitute have been exploited to conquer this problem.OsteoSet,a new substitute for bone graft,with the advantage of excellent biocompatibility,degradation,bone conduction and induction of ossification,is an ideal product.OBJECTIVE:To investigate the effect of OsteoSet in repairing bone defects due to tumor.DESIGN:Retrospective study and case analysis.SETTING:Department of Orthopaedics,First Hospital of Jilin University.PARTICIPANTS: Twenty-two patients with bone defect caused by bone tumor who received operation in the Department of Orthopaedics,First Hospital, Jilin University between June 2004 and September 2006.The involved patients,14 male and 8 female,averaged 23 years old ranging from 5 to 68 years.Inclusive criteria:① Diagnosed as benign tumor in bone according to the bone tumor classification criteria instituted in China in 1983.②Had the indications of tumorectomy and bone grafting with OsteoSet substitute.③Informed consent was obtained.The position of tumor was described as 6 in shaft of humerus,2 in neck of femur, 9 in inferior segment of femor, 4 in superior segment of tibia and 1 in celcaneus respectively.METHODS:①Operation procedure:After the effective anesthesia,the tumor was exposed as usual.Then the tumor was resected as thoroughly as we could.When OsteoSet substitute in the bone defect was filled carefully in order to avoid crushing into pieces.At last the substitute should be covered with periosteum or soft tissue.②Postoperative evaluation: The area of substitute absorption was observed by X-ray examination in 4, 8, 12 and 24 weeks after oporation.Postoperatively.incision healing,pain and complications of paients were observed at 6,7,8 and 9 months.MAIN OUTCOME MEASURES: OsteoSet substitute absorption rate and new bone formation rate as well as postoperative follow-up results.RESULTS:Twenty-two patients were involved in the final analysis.①OsteoSet substitute absorption rate and new bone formation rate:The evident absorption of OsteoSet substitute could be found in the X-ray film 4 weeks after operation.At the same time,the slender bone trabecula formed and bone density ncreased.At the end of 12 weeks after operation,about 97.1 percent OsteoSet substitute was absorbed and approximate 95.3 percent new bone infiltrated the defect area. In the 6 months, the substitute absorption rate and the new bone formation rate were 99.1 percent and 98.6 percent respectively. Stable bone trabecula formed in the bone defect area and the new bone connected with the surrounding health bone naturally by remolding.②Follow-up results:All the operative incisions healed well and there were no pain and discomfort in the duration of hospital stay; All the patients had no fever, erythra or other allergic responses during the follow up;The OsteoSet substitute were absorbed well and new bone also formed well in all the cases;All the patients were satisfied with the recovery of limb function.CONCLUSION:The substitute absorption was accordance with the new bone formation.For its good absorption and new bone reconstruction,OsteoSet is an ideal substitute for bone defect caused by tumor.

Cancer of digestive system is one of the most common worldwidely cancers and seriously threats to human health. However its etiology and pathogenesis are still not clear. Toll-like receptor (TLR), a newly discovered transmembrane receptor, plays an important role in innate immunity. Recent researches suggested that TLRs had extensive relationship with inflammation, autoimmune diseases and cancer. A large number of researches indicated that TLRs not only participated in the occurrence, development and immune escape of cancer, but also acted in immunotherapy in digestive system. Further investigation of TLRs may re-veal the effects of TLRs in the development of malignant tumors of digestive system, moreover may find new therputic target for the treatment of cancers. We reviewed the relationship between TLRs and cancers of di-gestive system.

Objective To evaluate the effectiveness of mild hypothermia and the intra-aortic balloon pump (IABP) in postcardiac surgical patients with severe heart failure. Methods Twelve patients took combination therapy of IABP and mild hypothermia after cardiac surgery, which did not improve the low cardiac output with massive doses of catecholamine, were included in this study. The values of cardiac index (CI), mixed venous oxygen saturation (SvO2), urine volume and creati-nine (Cr) were measured before and after treatment. Results After combination therapy of IABP and mild hypothermia, the value of CI was improved obviously [L/(min·m2):2.4±0.5 vs 1.6±0.2], the value of SvO2 increased (0.65±0.07 vs 0.52±0.05 ), urine output increased obviously [mL/(kg·h):2.9±1.9 vs 1.2±0.9 ] and the value of Cr decreased obviously (mmol/L:95±10 vs 282±25 ). Conclusion The combination therapy of mild hypothermia and IABP is an effective and simple procedure for the postcardiac surgical patients with severe heart failure.

Objective The K-ras gene plays a major role in the development , progression, and drug selection for the target treatment of colorectal cancer .The aim of this study was to evaluate the feasibility of detecting K-ras mutation in colorectal cancer by high-resolution melting ( HRM) analysis and to investigate the relationship between K-ras mutation and the clinicopathological parame-ters of colorectal cancer. Methods We collected the tissue samples of colorectal cancer from 179 patients, detected the mutations in codons 12 and 13 of the K-ras gene, and analyzed the relationship between K-ras mutation and the clinicopathological parameters of the patients. Results In the 179 cases of colorectal cancer, K-ras mutation was found in 77 (43.02%), significantly higher in those aged ≥60 years than in those aged <60 years (55.17% vs 33.70%, P<0.05).Multivariate logistic regression analysis showed a significant influence of age on K-ras mutation (OR=1.506, 95%CI:1.028-2.011, P<0.05). Conclusion HRM analysis is a rapid, sensitive, and inexpensive diagnostic tool for the detection of K-ras mutation, and K-ras mutation is associated with the age of colorectal cancer patients .

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 assess peritonitis rate in peritoneal dialysis. Methods The peritonitis rate from 1999 Aug. 1st to 2004 Jun 30th in Renji Peritoneal Dialysis Center was analyzed retrospectively. Various methods including cohort-specific peritonitis incidence, negative binomial distribution model, median subject-specific peritonitis incidence and peritonitis-free survival were used for the analysis. Results Cohort-specific peritonitis incidence was 1756. 14 patient-month, the mean peritonitis rate estimated using the negative binomial model was 1/49.58 patient-month, median subject-specific peritonitis rate was 0, mean peritonitis-free survival time was 39. 71 months, the peritonitis-free time was inversely correlated with subject-specific peritonitis rate(P

Objective To observe the effects of insulin pump therapy on type 1 diabetes mellitus children with diabetic keto or diabetic ketoa-cidosis(DK/DKA).Methods Forty-three children with DK/DKA were randomly divided into treatment group(n=26)and control group(n=17).The patients in treatment group were treated with insulin pump,control group were received small amount insulin injravenous injection.The changs of blood sugar,urine ketone bodies,incidence of hypoglycemia and length of stay were observed.Results 1.The effect of decreasing sugar was the same between two groups.2.There was no hypoglycemia events in treatment group.But 2 cases in control group had hypoglycemia.3.There was significant difference of length of stay between two groups(P