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.

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.

Objective To explore the mechanism of 125I seed interstitial implantation-induced apoptosis of liver VX2 tumor cells in experimental rabbits, and to compare the effects of different radioactivity 125I seeds on the apoptosis and on the proliferation of tumor cells. Methods A total of 24 rabbit models with VX2 liver cancer were randomly and equally divided into 3 groups, and 125I seeds with different initial radioactivity were separately implanted into the rabbits of the three groups. 125I seeds of 0 mCi radioactivity were used in the control group (n=8), 125I seeds of 0.7 mCi radioactivity were used in the 0.7 mCi group (n=8) and 125I seeds of 1.0 mCi radioactivity were used in the 1.0 mCi group (n=8). The experimental rabbits were sacrificed at 5 weeks after the implantation; the tumor lesions were removed, and the effects of 125I seeds on the apoptosis and proliferation of tumor cells were determined. The tumor cell apoptosis rate, tumor growth-related factors, tumor growth factor expression protein and the influence of caspase-3 activity were evaluated. Results Regardless of their initial radioactivity, all the 125I seeds could make the tumor cell apoptosis rate increased, make Bcl-2 and VEGF expression level decreased, and make Bax expression increased, which were more obvious in 1.0 mCi group (P<0.05). The 125I seeds could increase the activity of caspase-3 within tumor tissue, but the difference between the 0.7 mCi group and the 1.0 mCi group was not significant (P>0.05). Conclusion The implanted 125I seeds can not only inhibit tumor’s growth through inducing apoptosis of tumor cells, but also inhibit tumor’s angiogenesis through influencing the expression of apoptosis-related gene and coding protein.

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.

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.

OBJECTIVE:To provide reference for improving the service quality of outpatient pharmacy in hospital. METH-ODS:A questionnaire survey was conducted to investigate and analyze the patients’satisfaction and related influential factors to outpatient pharmacy in a third grade class-A hospital in Chengdu. RESULTS:Totally 165 questionnaires were sent out,and 150 were effectively received with effective recovery of 90.91%. The total score for patients’satisfaction was (44.67 ± 7.81) scores, and the rate of satisfaction was(81.22±14.19)%. The top three entries were“the will you choose to come to our hospital again if necessary”,“the notices about time and place for taking the medicine”and“the overall evaluation of the professional ethics of med-ical staff”,scored 4.38,4.25 and 4.25,respectively;the last three entries were“waiting time for taking medicine”,“the notices about how long it takes to take the medicine”and“service facilities and environmental facilities for drug taking”,scored 3.55, 3.63 and 3.95,respectively. The top three suggestions were“long waiting time for taking medicine and inconvenient”,“noisy envi-ronment,bad order”and“expensive drugs charges but less reimburse”. The univariate analysis and multivariate analysis showed that gender,age,marital status,education,occupation,family income per month,resident,drug taking times and payment etc. factors showed no significant effects on patients’satisfaction scores(P>0.05). CONCLUSIONS:The degree of patients’satisfac-tion in outpatient pharmacy have no obvious specificity and preference,the key to improve the degree of satisfaction lies on strengthening the service of the hospital and the perception of the patients. While the next research will focus on how to find the breakthrough points and key points to improve the experience of waiting,standardize process management and logistics manage-ment,and make patients aware of the service development.

Objective To observe the effect of calycosin on cisplatin?induced inhibition of human gastric BGC823 cells. Methods BGC823 cells were treated with different drugs:saline,cisplatin,calycosin and cisplatin combined with calycosin. MTT assays were used to detect the prolif?eration rate of BGC823 cell. Then the protein level and RNA level of cyclin D1,CDK4 and CDK6 were detected by Western blotting and Real?time PCR. Results The proliferation inhibition rates of BGC823 cells treated with 20μg/mL cisplatin,10μg/mL meperoflavone,and combina?tion of the 2 drugs were 56.44%± 2.08%,9.52%± 2.77%and 74.44%± 0.82%,respectively. The inhibition rate of the combination of drugs was significantly higher than that of the single drug treatment group(P<0.05). In addition,we found that calycosin can significantly enhance the inhi?bition of Cyclin D1,CDK4 and CDK6 by cisplatin in protein level and RNA level. Conclusion Calycosin can significantly increase the inhibitory rate of cisplatin on BGC823 cell proliferation,and the combination of the two drugs can reduce the side effects of cisplatin.

Objective To study the endogenous metabolites of liver-kidney deficiency syndrome in knee-joint osteoarthritis (KOA) and explore the metabolic profile of KOA liver-kidney deficiency syndrome. Methods Totally 50 cases of KOA with liver-kidney deficiency syndrome and 50 cases of KOA with non-liver-kidney deficiency syndrome were collected respectively, and 20 cases of healthy volunteers were collected as the normal group. The serum samples of subjects were collected after fasting for 8 h. Hydro-Nuclear Magnetic Resonance (1H-NMR) spectrometer was collected. Principal component analysis and partial least squares discrimination analysis were used to conduct multivariate statistical analysis. Results 1H-NMR could identify 23 kinds of metabolites, and there was statistical significance between KOA patients and healthy volunteers (P<0.05, P<0.01). There was statistical significance in cartilage matrix metabolism, energy metabolism, lipid metabolism, pain, inflammation-related metabolites in patients with KOA liver-kidney deficiency syndrome and patients with KOA non-liver-kidney deficiency syndrome (P<0.05). Conclusion Patients with KOA liver-kidney deficiency syndrome have a unique 1H-NMR metabolic profile, KOA syndrome has a metabolic material basis.