Objective To investigate the effects of partial prostatic capsula and surrounding striated sphincter sparing surgery on the function of intestinal orthotopic neobladder. Methods Total cystectomy and orthotopic intestinal neobladder was performed in 23 male patients with invasive bladder cancer. The patients were divided into classical cystectomy group (n=10) and modified cystectomy group (n=13).In the classical group the prostate was removed completely and the residual urethra was anastomosed with the neobladder using interrupted suture.In the modified group transurethral resection of the prostate preceded the cystectomy,and the prostatic capsula below the verumontanum with its surrounding striated urethral sphincter was retained.The neobladder was anastomosed with the residual capsula using continuous suture.The function of the neobladder in the 2 groups was evaluated and compared. Results The pathological classification of the 23 patients was as follows:T 2aN 0M 0,13 cases;T 2bN 0M 0,6;T 1N 0M 0,1;T 3aN 0M 0,1;T 3bN 1M 0,1;T 4aN 0M 0,1.The patients were followed up for 3 to 40 months(mean,15.7 months).In modified group,11 patients survived disease-free and 2 survived with metastasis.All the 13 patients voided well with residual volume of 0 to 70 ml.Complete urinary continence was achieved in 12 patients and the remaining one had nocturnal incontinence.In classical group,10 patients survived disease-free;of them 7 voided well with residual volume of 10 to 100 ml and the other 3 needed intermittent catheterization because of their residual urine being up to 100 to 250 ml.Complete continence was achieved in 7 patients and the other 3 were incontinent(1 with incontinence day and night,2 with nocturnal incontinence). Conclusions Partial prostatic capsula and its surrounding striated sphincter sparing surgery can improve the continence and voiding of the orthotopic neobladder.$$$$

Objective To investigate the possible role of protein kinase(PK) activity in the induction of AP-1 by ox-LDL in mesangial cells and to elucidate the upstream signal pathways involved in the ox-LDL-induced AP-1 binding. Methods Rat mesangial cells were randomly divided into the normal cells, ox-LDL-treated cells and PK inhibitor + ox-LDL-treated cells. Treatments with the PKC inhibitor bisindolylmaleimide I, the PKA inhibitor H89, the PTK inhibitor genistein (GEN), the MEKi inhibitor PD98059, or the p38 MAPK inhibitor SB203580 were applied prior to a 24-hour incubation of ox-LDL in mesangial cells. The phosphorylation of MAPK families was detected by Weatern blot analysis. AP-1 binding was determined by gel shift assay. Results Ox-LDL stimulated the phosphorylation of JNKi/SAPK and p38 MAPK( P 0. 05) . Bisindolylmaleimide I at 50, 100, 200 nmol/L appreciably reduced the ox-LDL-induced AP-1 binding. H89 at 0. 5, 5 umol/L significantly inhibited AP-1 binding by ox-LDL. GEN at 25, 50 umol/L did not reduce the AP-1 binding by ox-LDL, but when GEN rose up to 100 umol/L, the ox-LDL-induced AP-1 binding significantly decreased in mesangial cells. However, SB203580 and PD98059 did not reduce the ox-LDL-induced AP-1 binding in the present study. Conclusion Multiple protein kinases may involve in the stimulation of AP-1 by ox-LDL in mesangial cells.

This paper reports a simple method using the mesentery as a naturai mountingsubstrate for the study of mesenteric free cells under the scanning electron micros-cope.Mouse mesentery was cut into pieces about Ⅰ square centimeter in size andadhered on to neutral filter paper.The specimen were fixed in 5% glutaraldehyde and1% osmium tetroxide for 20 minutes,each step washed lightly with pH 7.4 PBS,dehydrated with ascending series of alcohol,put into amyl acetate,critical pointdried with CO_2,coated with gold and examined in scanning electron microscope.The morphologic features of free cells in the peritoneal lumen,such as polymorpho-nuclear leucocytes,macrophages and lymphocytes could be observed satisfactorily.We studied in particular the relationship between immunoreactive cells and targetcells(fetal liver cell)injected into the peritoneal cavity,Polymorphonuclear leuco-cytes could be seen invading into and eroding the target cells and macrophage cau-sing their swelling and lysis.Cooperative action of immunoreactive cells and anincrease in number of milk spots were also observed.

A general evaluation indexing system is constructed based on hospital specifics, in HR evaluation theory, on job orientation, HR competence, and by means of expert consultation and level of analysis. Four tier-1 indexes were earmarked as knowledge, basic competence, management capability, and research capability; 32 tier-2 indexes include education background, foreign language command, computer capability, legal knowledge, and professional knowledge, each having different weight. This indexing system enables hospitals to screen their management staff objectively, reliably and efficiently. Moreover, it serves as a reference not only for their recruitment, training, screening and promotion, but also for their personal development.

Objective To evaluate the effect of ultra-low dose naloxone on postoperative hyperalgesia caused by large-dose remifentanil.Methods Forty ASA Ⅰ-Ⅲ adult patients,scheduled for gastrointestinal surgery,were randomly assigned into 2 groups (n =20 each):large dose remifentail group (group R) and ultra-low dose naloxone group (group N).Anesthesia was induced with iv injection of remifentanil,propofol and cisatracurium and maintained with inhalation of sevoflurane and infusion of remifentanil.The patients were tracheal intubated and mechanically ventilated.In group R,remifentanil was infused at a rate of 0.25 μg· kg-1 · min-1 starting from the beginning of skin incision.The infusion rate was adjusted according to hemodynamics during operation and subsequently increased/decreased by 0.05 μg· kg-1· min-1 each time.In group N,naloxone was infused at 0.1 μg·kg-1· h-1 while infusing remifentanil,naloxone infusion was stopped at the beginning of peritoneum closure and the other treatments were similar to those previously described in group R.All patients were sent to post-anesthesia care unit after surgery and stayed there for 90 min.Morphine was given when need.The patient-controlled intravenous analgesia was used for postoperative analgesia after leaving post-anesthesia care unit.The first pain time was calculated.The morphine consumption and complications such as nausea,vomiting and pruritus were recorded at 15,30,60 and 90 min and 2,6,24,48 and 72 h after surgery.Results Compared with group R,the morphine consumption was significantly reduced at each time point after surgery,the first pain time was prolonged,and incidence of nausea was decreased (P ＜ 0.05),while no significant change was found in the incidence of vomiting and prutirus in group N (P ＞ 0.05).Conclusion Infusing ultra-low dose naloxone (0.1μg· kg-1 ·h-1) during operation can attenuate postoperative hyperalgesia caused by large-dose remifentanil in patients.

Objective To evaluate the possible association among serum folate,polymorphisms related reduced folate carrier gene (RFC-1) AS0G,methionine synthase reductase gene (MTRR) A66G,and cervical cancer,and to provide clues for the etiology of cervical cancer.Methods Based on a hospital-based case-control study,107 cases diagnosed as cervical cancer pathematologically and 107 controls with hysteromyoma,were selected by frequency,matched with age and habitation.Serum folate concentration was detected by RIA and polymorphism RFC-1 A80G and MTRR A66G was examed by RFLP-PCR.Results Serum folate concentration in patient group [(1.86±0.60) ng/rml] was significantly lower than that in control group [(2.30 ± 1.14) ng/ml],and risk of cervical cancer increased with the decreased serum folate levels (x2trend =12.57,P =0.001).Risks to catch cervical cancer for women with RFC-1 80 GG were 2.42 times (95 ％ CI 1.01-5.81) as much as for those with RFC-1 80 AA,and 1.65 times (95 ％ CI 0.77-3.53) for those with RFC-1 80 AA and RFC-1 80 AG,risks to catch cervical cancer for women with MTRR 66 GG were 1.35 times (95 ％ CI 0.40-4.56) as much as for those with MTRR 66 AA and 1.26 times (95 ％ CI 0.38-4.16) for those with RFC-1 80 AA and RFC-1 80 AG.Conclusion Serum folate deficiency to a certain degree can increase the risk of cervical cancer.RFC-1 A80G mutation may be a risk factor for cervical cancer and homozygous (GG) gene may increase the susceptibility of cervical cancer.MTRR A66G gene mutation may have nothing to do with cervical cancer.

Functional experiment is an important course to cultivate medical undergraduates'comprehensive and creative thinking abilities. Based on the conduction of the course, prominent teaching factors like the qualifies of teachers and students, the making of the courseware, the choosing of experiment contents and the arrangement of teaching progress,have been analyzed and practical teaching suggestions have also been proposed for a better functional experiment bilingual teaching quality.

A total of 1140 medical workers from 8 public hospitals of secondary and tertiary levels in Anhui were surveyed with questionnaire. Their knowledge of the reform, acknowledgement of key points of the reform, desire of participating in the reform and other factors that may influence the reform were investigated as categorized by their hospital, position, title and age. This study comes up with such recommendations as reinforcing communications on public hospital reform, reforming the compensation mechanism to clarify government responsibilities, probing into a better model for multi-institution practice of certified physicians, and encouraging private capital to participate in medical service while ensuring its non-profit nature, and improving the performance appraisal mechanism to ensure incentives of medical workers. These recommendations aim to enable the health administrators in their decision making.

Objectives:To investigate the level of soluble intracellular adhesion molecule 1 (sICAM 1) concentrations in the serum and peritoneal fluid from the patients with or without endometriosis.To discuss the relationship within sICAM 1 and pelvic endometriosis. Methods:35 serum and 30 peritoneal fluid of patients with endometriosis (test group) and 26 serum and 4 peritoneal fluid without endometriosis (control group) were studied.Soluble intracellular adhesion molecule 1 levels were detected by an enzyme linked immunoassay(ELISA).The results were analysed by T test. Results: The serum concentration of sICAM 1 was significantly higher in test group than controll group. However,There was no significant difference in between two groups. Conclusions: These results suggest that sICAM 1 could play some role in the persistence of endometriotic lesions.

Objective To probe into the reliability and validity of the questionnaire on clinical pathways and patients' satisfaction.Methods Investigating the hospital patients' satisfaction with the questionnaire designed by the former Ministry of Health and analyzing the internal consistency and constructive validity through statistical methods.Results Cronbach' s α coefficient of the adjusted questionnaire was 0.947 and those of the each subscale were 0.563,0.968 and 0.820.The split-half reliability of the questionnaire was 0.869.The number of factors is 3 as same as the designed assuming structure,and the cumulative contribution rate of 3 factors was 74.178％.The factor loading of each item was above 0.4,each item of a common factor with a higher load factor.Conclusion Although there are differences from hospital to hospital,this questionnaire is applicable to investigating patients' satisfaction of the clinical pathway management mode in view of the statistical and clinical practice.