Objective To survey cognitive and processing mode of urethral distraction defect associated with pelvic fracture (PFUDD) in China and hope to find a reasonable treatment scheme for (PFUDD).Methods From Jan 2011 to Dem 2015,a questionnaire on surgical treatment for PFUDD was sent to 286 Chinese consultant urologists in more than 56 comprehensive hospitals throughout the China.The investigation includes the age of urologsit,the type of hospital,the number of patients treated during the last 5years,operation mode and optional time to do the surgery,the selection of operation approach,evaluation of the treatment effect were analyzed.At same time,we also investigated the methods of 260 cases about PFUDD.Results The age of the urologist were 30-55 years old.Over the past five years,229 urologists had fewer than 10 patients diagnosed each year,and only 57 had 10 patients diagnosed each year.There were many different kinds of operation method,including urethral realignment 36 (14％),direct vision internal urethrotomy 121 (46％),internal urethrotomy plus laser 57 (22％),trans-perineal urethral anastomosis 46(18％).The success rates were 58％ (21/36),50％ (60/121),46％ (26/57),76％ (35/46)respectively.70％ (200/286) of specialists did an open exploration urethral realignment or cystostomy when patients were injured in 2-6 hours.28％ (80/286) of specialists did urethral realignment with endoscopic surgery.About 75％ (216/286) of specialists believed that the treatment of patients with posterior urethral atresia should follow the ladder principle.Minimally invasive methods at the start,including urethral dilation,direct vision internal urethrotomy was the first choice.They would prefer open surgery only after intial treatment failure.65％ (186/286) of doctors believed that the overall outcome of the surgery was moderated.Conclusions Urethral distraction defect associated with pelvic fracture (PFUDD) was rare to be done.The direct vision internal urethrotomy was the first choice for most of the urologists(75％).They considered the urethroplast only after the failure of initial mini-invasive surgery.Trans-perineal urethral anastomosis had the best results.

Objective To investigate the clinical efficacy of modified YV-plasty for refractory bladder neck contracture (BNC) caused by transurethral resection of prostate (TURP).Methods From June 2013 to March 2016,11 patients with BNCs secondary to TURP were included in this study.Their mean age was 63.7 years (range,56-73 years).All patients presented voiding difficulty and failed after 2 or more prior endoscopic treatments.Modified YV-reconstruction of bladder neck was performed,by incising the anterior wall of bladder neck in a T-shaped manner,and creating two well-vascularized and tension-free flaps,which offer the possibility to reconstruct a wide bladder neck.Results After a mean follow-up of 14.6 months (ranging 3-24 months),successful outcome was achieved in 9 patients without incontinence secondary by surgery.Recurrent voiding difficulty developed in 2 patients,which was cured after a following endoscopic treatment.Conclusion A wider bladder neck can be obtained through modified YV-reconstruction of bladder neck,while avoiding external urethral sphincter injury.It is an available option for refractory bladder neck contracture.

Objective To investigate the risk factors of pelvic fracture related urethral injury (PFUI).Methods We retrospectively reviewed 120 patients with pelvic fracture from March 2014 to October 2016 in our hospital.Of all the patients,87 were males and 33 were females.The average age was (42.6 ± 15.4) years old (ranging 1 1-78 years old).The etiology of pelvic fracture included traffic accident in 70 cases,fall injury in 27 case.Heavy crash in 23 cases.43 male patients had an PFUI.Their average age was (40.4 ± 14.5) years old (ranging 14-61 years old).Of PFUI patients,the location of urethral injury included membranous part in 16 cases,bulbomenbranous part in 17 and prostatic part in 10 cases.The average length of stricture was (3.0 ± 1.9) centimeter.One patient suffered the stricture,combined with bladder rupture.One patient had urethro-rectal fistula.Two patients had urethrocutaneous fistula.The pelvic fractures were categorized using Tile classification,including type A1 fractures in 10 cases,A2 in 10 cases,B1 in 14 cases,B2 in 31 cases,B3 in 42 cases,C1 in 2 cases and C2 in 11 cases.The patients' number of urethral injury in each type was 1,2,2,7,29,0,2,respectively.Hazard degree analysis and chisquare test were used to evaluate the risk factors.Variables with an association of P ＜ 0.05 were then tested using binary logistic regression and the area under the curve(AUC).Results On hazard degree analysis,female(x2 =25.419,P ＜ 0.05,OR =0.571) and type B3 fracture (x2 =31.002,P ＜ 0.05,OR =10.198)have a significant impact on the occurrence of PFUI.On binary logistic regression,female(Walds =16.528,P ＜ 0.05,adjusted OR =0.003)is the protective factor of PFUI while type B3 fracture (Walds =10.853,P ＜0.05,adjusted OR =28.537) is the risk factor.The area under the curve (AUC =0.891,95％ CI0.826-0.956) illustrates the regression model has a high credibility.Conclusions Pelvic fracture urethral injury is much less likely to occur in females than men.Type B3 fracture is more likely to cause an PFUI than the others type.

Objective To investigate the quality of life in young patients with hemodialysis and influencing factors .Methods Totally 128 young patients aged 18-44 years old with maintenance hemodialysis were performed the questionnaire investigation by using the self‐designed demographic information questionnaire ,Medical Outcomes Study Health Status Short Form (SF‐36) , Herth Hope Index(HHI)and Social Support Rating Scale(SSRS) .Results The mean total score of physical health in the hemodial‐ysis young patients was (202 .49 ± 53 .94) points and the mean total score of mental health was (190 .85 ± 77 .81) points .In the va‐rious dimensional scores of living quality ,the scores of physical functioning and bodily pain were highest ,while the scores of physi‐cal function and emotional function were lowest ,moreover the scores of various dimensions were lower the the national norm (P<0 .01) .The multiple regression analysis showed that the quality of life was significantly correlated with hope level ,social support and economic condition ,which could explained 62 .8% of living quality variation amount .Conclusion The quality of life in hemodi‐alysis young patients needs to be improved .The medical care workers formulate the intervention measures ,meanwhile should pay attention to enchance patients′hope leve and social support .At the same time it is appealed that the government helps to solve the patients′economic problem in order to better improve their living quality and promote them return to society .

Objective To study the effect of brucine on the growth of a hepatocellular carcinoma cell line in vitro. Methods Brucine was added into a liver cancer cell line of SMMC-7721 in vitro, at drug concentration of brucine from 2. 5 μg/ml to 400 μg/ml. The inhibition rate of cell growth was measured by MTT technique after the cells were cultured for 72 hours. The protein and mRNA expression of PCNA,cyclin D1 and FAS were respectively assayed with Western blotting and fluorescent quantitation RT-PCR techniques at 24, 48, 72 h. Results The inhibition rate of liver cancer cell was near 100% when the brucine concentration was at 320 μg/ml. The protein and mRNA expression of FAS were of no significant difference at 24 h vs 48 h ( seperately F = 2. 547,1. 582, all P ＞ 0. 05 ), and significant difference existed at 24 h vs 72 h( seperately F = 1. 036, 1. 137, all P ＜ 0. 05 ). The protein and mRNA expression of PCNA,Cyclin D1 were of no significant difference between various time period( seperately PCNA F = 3.612,2. 174,3.029;Cyclin D1 F=2.361,2.915,1.976,all P＞0.05). Conclusions Brucine inhibits the growth of liver cancer cells, by inducing increased apoptosis of the cells probably through FAS overexpression.

Objective To examine the status of self-perceived burden in patients with continuous ambulatory peritoneal dialysis and explore the relationships among social support,coping styles and self-perceived burden.Methods 103 elderly patients with peritoneal dialysis of outpatient follow-up were recruited.They were investigated using Self-Perceived Burden Scale,Social Support Rating Scale,and Simplified Coping Style Questionnaire.Results The total score of self-perceived burden was at a moderate level and the average score was (36.67±3.67).The total score of social support,the average score of positive coping and negative coping were (40.27±5.83),(1.69±0.26),(1.80±0.40),then the difference was statistically significant when compared with domestic norm (34.56±3.73),(1.78±0.52),(1.59±0.66) (P＜0.05).The analysis found that self-perceived burden was negatively correlated with positive coping styles,social support and each dimension (r =-0.239,-0.668,-0.725,-0.252,-0.647,P＜0.05).Conclusions Medical personnel should inspire elderly patients to make full use of social resources and guide them to take positive attitude to deal with dialysis event.It would help them maintain well psychological condition for a long time and reduce the self-perceived burden of patients.

This study is to explore characteristic indexes in evaluation criteria for rat skin anaphylactoid test comparing skin blue spot OD values at the treated position and the control position in the same animal. Common contrast agents, traditional Chinese medicine injections and injections' active pharmaceutical ingredients or excipients in the existing clinical anaphylactoid reaction reports were taken as test drugs in the rat skin anaphylactoid test to define the K value: K > 2 represents positive anaphylactoid reaction, 1.2 ≤ K ≤ 2 represent doubtable anaphylactoid; K < 1.2 represents negative anaphylactoid reaction, which were taken as the criteria for evaluating anaphylactoid of tested drugs. The evaluation result and that for classic criteria were compared to study the applicability of K value. According to the comparison, K value, as the evaluation criteria in the rat skin anaphylactoid test, can more truly reflect the actual situation of skin aizen and minimize the error caused by animal individual factors. Compared with positive and negative two-level criteria for blue spot diameter, K value's positive, doubtable and negative three-level criteria are more objective and accurate. Therefore, K value can be used as the evaluation criteria in the rat skin anaphylactoid test.
Animals ; Drug Hypersensitivity ; immunology ; Drugs, Chinese Herbal ; adverse effects ; Female ; Humans ; Rats ; Rats, Sprague-Dawley ; Skin Tests ; methods

Objective To observe the therapeutic effect of brucine nanoparticles on hepatocellular carcinoma.Methods Brucine nanoparticles with block copolymer of carboxylation polyethylene glycol and polylactic acid were manufactured by ultraphonic emulsification.The effect brucine nanoparticles on growth of SMMC-7721 cell line was observed in vitro.The protein and mRNA levels of Fas were measured with Western blotting and FQ-PCR respectively after the brucine nanoparticles were added into cell culture fluid for 72 hours.Results The mean diameter,the carried drug rate and the entrapment rate of brucine nanopaticles was 146±96 nm,4.2％ and 67％,respectively.The growth inhibition of liver cancer cells was enhanced significantly with the increasing drug dose.The IC50 of growth inhibition of 5-FU,brucine and brucine nanoparticles was 16.7 μg/ml,90.3 μg/ml and 164.9 μtg/ml,respectively.There was significant difference among them (P＜0.05).The protein and mRNA expression of Fas in brucine nanoparticles treated SMMC-7721 cells increased significantly compared with that in blank control group(P＜0.05).Conclusion Brucine nanoparticles may potentially be a novel therapeutic drug for hepatocellular carcinoma.

Objective To observe the clinical significance and effect of dysfunction of dendritic cell( DC) in colorectal cancer with liver metastasis.Methods Peripheral blood were respectively collected from healthy adult donors (30 cases), preoperative and postoperative coloreatal cancer patients without liver metastasis (30 cases) , and 30 postoperative coloreatal cancer patients with liver metastasis from Jan 2008 to Jun 2010.Peripheral blood mononuclear cells were separated, GM-CSF( 1000 U/ml) , IL-4( 1000 U/ml) and TNF-α ( 1000 U /ml) were added into cell culture fluid to induce the mononuclear cells for mature dendritic cells.There were two subgroups, and in antigen processing subgroup the lysate of HT29 colonic carcinoma cells (100 μg/ml) were added into the cell culture fluid.The T lymphocytes from healthy adults were added into two subgroups by ratio of 1∶10 ( DCs∶ T cells) , cocultured for 7 days.The level of INF-γ and IL-10 in cell culture fluid was assayed with ELISA method.The optical density (OD) of CCK8 ans LDH was assayed with ELIASA to indirectly measure the reproductive activity and the killing efficacy of T lymphocytes.Results The IL-10 level in cocultured fluid of peripheral blood DCs in postoperative colorectal carcinoma patients with liver metastasis and T lymphocytes of healthy adults was significantly higher than that of preoperative patients of colorectal carcinoma and health adults without tumor antigenic stimulation(11.9±1.3) pg/ml vs.(29.6±9.7) pg/ml, (23.4±8.0) pg/ml, F =4.475, P ＜0.05).The IFN-γ level in cocultured fluid of peripheral blood DCs in postoperative colorectal carcinoma patients with liver metastasis and T lymphocytes of healthy adults was significantly higher than that of postoperative patients of colorectal carcinoma and healthy adults with or without tumor antigenic stimulation ( 34 ± 9) pg/ml vs.(26 ± 12 ) pg/ml, (24 ± 6) pg/ml, F = 5.206, P ＜ 0.05).The killing activity of healthy adults T lymphocytes induced by HT29 colonic carcinoma cells in postoperative colorectal carcinoma patients with liver metastasis was significantly higher than that of preoperative patients of colorectal carcinoma and healthy adults (30.6 ±8.6) pg/ml vs.(12.1 ±2.4) pg/ml, (14.9 ± 1.7) pg/ml, F =4.147, P ＜ 0.05).Conclusions T lymphocytes produce IL-10 when indued by DCs from patients with colorectal carcinoma under stimulation of tumor antigen leading to tumor immune escape and liver metastasis.The killing activity of T lymphocytes can be enhanced when stimulated by exogenous tmuor antigen.

ObjectiveTo evaluate the one-year follow-up of the therapeutic efficacy of human umbilical cord derived-mesenchymal stem cell (UC-MSC) transplantations in decompensated liver cirrhosis patients with ascites.MethodsFifty-four liver cirrhosis patients with ascites in Research Center for Biological Therapy in 302 Military Hospital were divided into treatment group (n=38) and control group (n=16) in a prospective controlled single-blinded trial.UC-MSC (0.5-1.0) × 106/kg and saline were intravenously transplanted into patients monthly for 3 times in treatment group and control group,respectively.The liver function,hepatitis B virus (HBV) DNA level,ascites and the model for end-stage liver disease(MELD)scores at different time points were compared between two groups.The comparison between groups was done by Mann-Whitney U test,and the data before and after transplantations were compared by Wilcoxon signed rank sum test.ResultsThere were no significant differences of alanine transaminase (ALT),total bilirubin (TBil),cholinesterase (CHE),HBV DNA positive rate and MELD scores at different time points between two groups (P＞0.05).However, the albumin ( A1b)level was significantly increased after 36 weeks of UC-MSC transplantation in treatment group, which were (28.47±4.45)g/L at week 0 and ( 34.82±4.50)g/L at week 48 (P=0.046). Meanwhile, the ascites reduced markedly in treatment group with (46.6 ±30.6) mm at week 0 and (6.6±13.6) mm at week 48,which were significantly different from control group at the end of follow-up (P =0.037). Conclusion UC-MSC transplantations may help to increase A1b level and reduce ascites in patients with decompensated liver cirrhosis.